Structured medication reviews for patients with polypharmacy in primary care: a cross-sectional study in North West London, UK.

Objectives: To identify the number and characteristics of patients with polypharmacy receiving structured medication reviews (SMRs) and medication reviews in primary care in 2022, and to evaluate whether the provision of these services is equitable across different demographic and socio-economic groups. Design: Cross-sectional study. Setting: Primary care networks in North West London, UK. Participants: Adults registered with a general practitioner (GP) and regularly prescribed at least five medicines or more. Main outcome measures: Receipt of at least one SMR and any kind of medication review during the study period (2022). Results: Among 515,042 adults regularly prescribed with medication, 167,482 were regularly prescribed at least five medicines, defined as polypharmacy. 53.3% (89,220) of these patients received at least one kind of medication review and 17.2% (11,954) of them received SMRs. Patients who were males, black, more affluent, and frailer, were more likely to receive medication reviews, while those who were males, less affluent, and frailer, were more likely to receive SMRs. Conclusions: Although polypharmacy was common in North West London, only about half of eligible patients received medication reviews, and only 17.2% received SMRs. Different distributions of medication reviews and SMRs by demographic and socio-economic characteristics may indicate inequities in the provision of these services. Policy makers should consider effective ways to incentivise the equitable provision of SMRs.