Posted on August 26, 2019

It is the general practitioner (GP) who is left to decide what to do when the bemused patient asks “Should I take the aspirin?” according to one specialist’s advice, or “Should I stop the aspirin?” as instructed by another.

It harks back to the old conundrum posed by The Clash in 1981: “Should I stay or should I go now?” The problem is that one option “could be trouble”, while the other “could be double [the trouble]”.

GPs are problem-solvers. For some problems, two heads are better than one. Peer discussion of difficult cases is commonplace when GPs converge, be it in group practices, on the curbside or at CME. General practice cottoned on to the benefits of collaboration long before Chris Tarrant gave his quiz show contestants the option to phone a friend.

The increasing complexity of our patients in general practice is evident in the increasing multimorbidity we all encounter on a day-to-day basis. Multiple patients with multiple diagnoses on multiple medications!

National University of Ireland Galway (NUI Galway) are running a pilot study in collaboration with Queen’s University Belfast looking at drug prescribing in such patients.

The intervention, called MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE), was developed by Dr Carol Sinnott in conjunction with GPs.

The idea is that GPs would do a face-to-face medication review with a colleague to decide if the multimorbid patient’s prescription needs to be adjusted. Each participating intervention practice would be asked to do 20 such medication reviews.

There is support available to recompense participating GPs for their time. The research project in the Republic is led by Prof Andrew MurphyDr Lisa Hynes and Dr Scott Walkin. Research staff will be available to minimise the impact on practice time. Participating GPs will also be offered support to fulfill their clinical audit requirements for professional competence purposes. Practices in the northwest with two or more GPs are eligible to participate.

By: Dr. Scott Walkin (Mayo GP and NUI Galway lecturer at the Sligo Hospital campus

Applications are open for 2024 now.

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