In old age, people accumulate more diseases, use more medications and are more vulnerable to adverse effects. Internationally, polypharmacy (the use of 5 or more medications) is prevalent among older adults and is associated with an increased risk of adverse outcomes, such as adverse drug reactions, impairments of physical and cognitive function, falls, frailty, hospitalisation and mortality.
One approach to manage polypharmacy is deprescribing, which is the process of withdrawal of inappropriate, harmful or unnecessary medication, aiming to reduce medication-induced harm and improve health outcomes.
Clinically, it is difficult to (i) predict who will experience adverse outcomes with polypharmacy; (ii) distinguish medication-induced harm from other causes of adverse outcomes; and (iii) predict outcomes of deprescribing in an individual.
We do not know what the effects of polypharmacy and deprescribing are on biological pathways, or how these biological changes affect clinical outcomes. Understanding factors that contribute to variations in response and predictors of response could guide clinical prescribing and deprescribing. We aim to use the UK Biobank to answer these unknowns.
This data will advance personalised medicine for older people by informing medication optimisation including deprescribing decisions.