ObjectivesWhile older age and ill health are known to be associated with polypharmacy, this paper aims to identify whether wealth, body mass index (BMI), smoking and alcohol consumption are also associated with polypharmacy (5–9 prescribed medications) and hyperpolypharmacy prevalence (≥10 prescribed medications), among older people living in England.DesignCross-sectional study.SettingThe English Longitudinal Study of Ageing Wave 6 (2012–2013).Participants7730 participants aged over 50 years.Data synthesisTwo multivariate models were created. HR with corresponding 95% CI, for polypharmacy and hyperpolypharmacy, were calculated after adjusting for gender, age, wealth, smoking, alcohol consumption, BMI, self-rated health and the presence of a chronic health condition.ResultsLower wealth (lowest wealth quintile vs highest wealth quintile, adjusted HR 1.28; 95% CI 1.04 to 1.69, P=0.02) and obesity (adjusted HR 1.81; 95% CI 1.53 to 2.15, p<0.01) were significantly associated with polypharmacy. Increasing age (50–59 years vs 70–79 years, adjusted HR 3.42; 95% CI 2.81 to 4.77, p<0.01) and the presence of a chronic health condition (adjusted HR 2.94; 95% CI 2.55 to 3.39, p<0.01) were also associated with polypharmacy. No statistically significant association between smoking and polypharmacy (adjusted HR 1.06; 95% CI 0.86 to 1.29, P=0.56) was established; while, very frequent alcohol consumption (consuming alcohol >5 times per week) was inversely associated with polypharmacy (never drank alcohol vs very frequently, adjusted HR 0.64; 95% CI 0.52 to 0.78, p<0.01). The adjusted HR for hyperpolypharmacy was accentuated, compared with polypharmacy.ConclusionThis study has identified that lower wealth, obesity, increasing age and chronic health conditions are significantly associated with polypharmacy and hyperpolypharmacy prevalence. The effect of these factors, on polypharmacy and especially hyperpolypharmacy prevalence, is likely to become more pronounced with the widening gap in UK wealth inequalities, the current obesity epidemic and the growing population of older people. The alcohol findings contribute to the debate on the relationship between alcohol consumption and health.

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Background There is evidence to suggest that adherence with prescribed medication is lower amongst adolescents and children than in adults (1). Medication adherence rates between 11% and 93% in paediatric patients have been reported (2). More research needs to be carried out in order to understand why medicines adherence is low and how adherence can be improved in children with long-term conditions. Personal communication with paediatricians in secondary care has highlighted that problems are most likely to be encountered by parents, carers, nurses and children themselves when administering medicines for prevalent long-term childhood conditions. Objective To explore problems with oral medicines prescribed to paediatric patients from the perspectives of medical practitioners, pharmacists and nurses. Setting Two NHS trusts in the West Midlands, UK Method Four focus groups (FG) were conducted. 5 nurses, 8 medical practitioners and 6 pharmacists participated in focus groups.. The themes explored were problems experienced when prescribing, dispensing and administering oral medicines for children. Ethical approval was granted by the South Birmingham Research Ethics Committee (REC), UK. Main outcome measure Themes evolving from Healthcare professionals reports on problems with administering medicines to paediatric patients. Results Two main themes: sensory and non-sensory emerged from the data. Included within these were taste, texture, colour, smell, size, swallowing, quantity, volume and manipulation with food. Taste was the most commonly reported barrier to medicines administration. Texture was reported to be a significant problem for the learning disability population. Medicines manipulation techniques were revealed across the groups, yet there was limited knowledge regarding the evidence base for such activity. Problems surrounding the supply of Specials medicines were discussed in-depth by the pharmacists. Conclusion Organoleptic and physical properties of medicines were identified as key barriers to medicines administration. A robust scientific evidence-based approach is warranted to inform standardised protocols guiding healthcare professionals to support safe and effective medicines manipulation across all settings. Pharmacists' knowledge of Specials medicines needs to be recognised as a valuable resource for doctors. Findings of this study should help to optimise paediatric prescribing and direct future formulation work. Keywords: pediatrics;healthcare professionals;medicines administration;medicines adherence;prescribing.  A large number of issues are perceived by healthcare professionals to cause problems when administering oral medicines to children. Taste was highlighted as the most significant issue.  Nurses had the greatest knowledge of bedside issues, whilst pharmacists understood the consequences of certain manipulations; wider sharing of this knowledge can help to ensure appropriate medicines are prescribed to minimise issues with administration.  The scientific evidence base for medicines manipula...