{
  "abstract": "Background In October 2021, the National Health Service (NHS) introduced the structured medication review (SMR), a comprehensive review of patients’ medications aimed to decrease over-prescribing and reduce adverse drug-related outcomes for older people with severe frailty. This project aimed to examine differences in SMR among those aged 65+ with severe frailty according to age, ethnicity, socioeconomic status and rurality of GP practice in England.Methods Using Clinical Practice Research Datalink (CPRD) data on patients aged 65+ with severe frailty, who were not residing in a care home, between October 2021 and June 2024. We reported the incidence of SMR according to age (65–69, 70–74, 75–79, 80–84, 85–90, and ≥ 90 years), ethnicity (ONS census subgroups), index of multiple deprivation (IMD, quintiles), and rurality of general practice (GP) location (urban, rural). Analyses were generated using R v 4.2.1. Results are displayed as frequencies and percentages (%).Results There were 337,754 patients aged 65 and above with severe frailty, of whom111,313 (33%) of received an SMR. The incidence of SMRs decreased with increasing age, with 8,061 patients aged 65–69 (37.1%) having an SMR versus 22875 people aged 90 years and above (29.9%). Males were less likely to receive an SMR (39,597 (32.1%)) compared to females (71,715 (33.5%)). According to their IMD, patients in the less deprived areas (quintile 4: 21,893 (33.5%) and quintile 5: 22,687 (33.9%)) are more likely to have an SMR. Differences by ethnicity shows that patients with any other Asian background (1,053 (39.0%)), any other black background (264 (42.9%)), white and black African (105 (40.7%)), and Arab (74 (42.3%)) ethnic background are more likely to have an SMR compared to Chinese (138 (34.8%)), white British (88,634 (33.3%)), Gipsy or Irish traveller (12 (30.8%)), any other white background (5,358 (34.7%)). Patients registered at a GP in an urban area (97,456 (33.3%)) were more likely to have an SMR than those in a rural area (n%).Conclusion Between 2021 and 2024, only a third of patients with severe frailty received an SMR. SMRs were more common in younger people, those living in the least deprived areas of England, those registered at an urban GP practice. The uptake of SMRs also varied according to ethnicity. We next to plan to report rates of SMR according to combination of these characteristics using MAIHDA (spell out!) models.",
  "authors": [
    {
      "affiliations": [
        "Academic Unit of Ageing and Stroke Research, University of Leeds, Leeds, UK"
      ],
      "name": "Jose Ignacio Cuitun Coronado"
    },
    {
      "affiliations": [
        "Academic Unit of Ageing and Stroke Research, University of Leeds, Leeds, UK"
      ],
      "name": "Kate Best"
    },
    {
      "affiliations": [
        "Academic Unit of Ageing and Stroke Research, University of Leeds, Leeds, UK"
      ],
      "name": "Andrew Clegg"
    }
  ],
  "title": "P46 Structured medication reviews for older people with severe frailty: exploring inequalities",
  "uid": "d5138be0-6113-509b-8880-dba0d6b91a88"
}