Polypharmacy

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Clinical Terms
Polypharmacy refers to the concurrent use of multiple medications by a patient, typically older adults, often defined as five or more medications.

Clinical significance of Polypharmacy

What is ?

Polypharmacy describes the situation where a patient takes multiple medications simultaneously, commonly defined in the UK as the regular use of five or more medicines. While sometimes clinically necessary, polypharmacy carries risks of adverse drug reactions, drug interactions, medication errors, reduced adherence, and increased treatment burden. In primary care networks, managing polypharmacy involves regular medication reviews, deprescribing inappropriate medicines, and ensuring treatment is aligned with patients' priorities and needs.

Polypharmacy Best Practices

What is ?

  • Conduct structured medication reviews for patients on multiple medications, prioritising those at highest risk
  • Use validated tools like STOPP/START criteria or NO TEARS to guide deprescribing decisions
  • Involve pharmacists in multidisciplinary team approaches to medication optimisation
  • Maintain accurate medication records and ensure reconciliation across care transitions
  • Engage patients in shared decision-making about their medication regimen

Use Polypharmacy in a Sentence

What is ?

  1. The clinical pharmacist identified potential issues with polypharmacy in several elderly patients at the practice.
  2. PCN teams are implementing structured approaches to address polypharmacy and reduce unnecessary medication burden.
  3. Managing polypharmacy effectively requires collaboration between GPs, pharmacists, and other healthcare professionals within the PCN.
Frequently Asked Questions about
Polypharmacy

What does Polypharmacy mean?

Polypharmacy refers to the concurrent use of multiple medications by a patient, typically defined in the UK NHS as the regular use of five or more medicines. While sometimes necessary for patients with multiple conditions, polypharmacy can lead to adverse drug reactions, interactions, medication errors, and reduced adherence to treatment plans.

What are the risks associated with Polypharmacy?

Polypharmacy carries several risks, including increased likelihood of adverse drug reactions, potentially harmful drug interactions, medication errors, higher hospitalisation rates, falls in the elderly, and reduced medication adherence. It can also create a significant treatment burden for patients, particularly older adults, leading to confusion about medication regimens and reduced quality of life.

How do Primary Care Networks manage Polypharmacy?

Primary Care Networks manage polypharmacy through structured medication reviews conducted by clinical pharmacists and GPs, using validated tools like STOPP/START criteria to identify inappropriate medications, implementing deprescribing initiatives, ensuring medication reconciliation across care transitions, and engaging patients in shared decision-making about their treatment plans. PCNs often employ specialist pharmacists to support practices with these activities.

When is Polypharmacy appropriate or necessary?

Polypharmacy may be appropriate and necessary when patients have multiple co-existing conditions requiring different treatments, when following evidence-based guidelines for complex conditions, or when medications are used to counteract side effects of essential treatments. The key distinction is between "appropriate polypharmacy" where all medications have clear indications and benefits that outweigh risks, and "problematic polypharmacy" where medications are used without clear indications or create more harm than benefit.

How can patients help manage their own Polypharmacy risks?

Patients can help manage polypharmacy risks by maintaining an up-to-date list of all medications (including over-the-counter and herbal remedies), asking healthcare providers about the purpose and potential side effects of each medication, requesting regular medication reviews, using pill organisers or dosette boxes, reporting any side effects promptly, and actively participating in decisions about starting or stopping medications during consultations with healthcare professionals.

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