DANGERS OF POLYPHARMACY

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Polypharmacy is the use of multiple medications (5 or more) to treat a patient.
It is not only unpleasant but also extremely problematic. This is a common occurrence amongst the elderly.

CATEGORIES

  1. Excessive polypharmacy; i.e concurrent use of 10 or more medications.
  2. Polypharmacy; i.e use of 5 to 9 medications.
  3. No polypharmacy; i.e use of 4 or less medications.

ISSUES OF CONCERN

  1. Adverse effects due to metabolic changes and reduced drug clearance that comes with age.
  2. Drug interaction such as acute kidney injury, hypotension and delirium.
  3. Inappropriate therapy or non-adherence.
  4. Prescribing cascades. Etc.

ASSOCIATED FACTORS

Individual/patient

  1. Increasing age.
  2. Poor self reported health.
  3. Multiple chronic conditions.
  4. Self medication.

Physician

  1. Lack of education/competence.
  2. High patient workload.
  3. Poor physician-patient communication.
  4. Multiple prescribers

System-level

  1. Different electronic medical record system.
  2. Poor physician-physician communication.

MANAGEMENT
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