This clinical intervention reduced the number of medicines prescribed to elderly people in nursing homes, with minimal impact on their morbidity and mortality.

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The execution and incorporation of research into practice is in uenced by the relevance and credibility of the work undertaken. Part of this process can be to identify priority research questions from the service provider perspective. We sought to obtain a multidisciplinary consensus on priority research questions around the broad issue of prescribing in an inner London Primary Care Group locality. Participants were drawn from general practice, primary care nursing and community pharmacy. This paper explores how two formal consensus methods were used to facilitate multidisciplinary participation within the research arena, and the extent to which a convergence of opinion between professional groups was obtained. The use of a structured nominal group interview technique abated professional dominance and generated a diverse array of research questions. An iterative Delphi process secured a wide consensus of opinion regarding the relevance of these questions to practice. The richness of the research questions generated was attributed to the consultation process and the ability of the consensus methods used to capture the multidisciplinary perspective. The practice based research questions identi ed were diverse and suited to a collaborative research approach.

The National Health Service (NHS) spent £10 billion (40%) of its total budget on people aged 65 and over in 1998/1999. The profile of the health and social care of older people has been raised recently by the publication of the National Service Framework (NSF) for Older People (Department of Health, 2001). The NSF contains standards that older people can expect when they receive health and social care (Box 1). The document also discusses in detail medication management issues in older people. Its two aims in this area are to ensure that older people gain the maximum benefit from their medication in order to maintain or improve quality and duration of life, and do not suffer unnecessarily from illness caused by excessive, inappropriate or inadequate consumption of medicines.