What is polypharmacy?
Polypharmacy is an umbrella term used to describe the use of multiple medications taken daily by an individual. There is no one clear definition for polypharmacy. A common and widely used definition is one that says that polypharmacy refers to the use of five or more medications daily.
This definition is problematic as it does not consider the reasons why a particular individual is taking medication. Hence the suggestion that we need to differentiate between appropriate polypharmacy and inappropriate polypharmacy. Simply put many medications vs “too” many medications.
What are the causes of polypharmacy?
There are a number of factors that contribute to polypharmacy ,we will focus on just a few of them.
- Co-morbidities: This refers to a situation were one has been diagnosed with more that one condition that needs them to take medication. An example of such will be someone diagnosed with Diabetes and Asthma.
- Multiple prescribers: A person being seen by different providers and receiving prescriptions from all of them.
- Multiple pharmacies: Collection of medications from different pharmacies, this has been further complicated by the introduction of courier pharmacies for the delivery of chronic medications.
- Prescribing cascade: The prescribing of a new medication to “treat “an adverse reaction or side effect from another medication. This adverse reaction or side effect would have been mistaken for a new condition that has developed.
- Zombie medications: This refers to medications that a person may be taking yet no one knows for sure why they are there. This normally happens after hospitalisation. Medicines would have been added in hospital often meant to be used for a short period of time, but they just keep getting prescribed. These often include sleeping tablets, pain medications and acid reflux tablets.
Dangers of Polypharmacy
- Polypharmacy increases the risk of developing adverse reactions to medication.
- Poses challenges with adherence (how one takes their medication).
- Affects quality of life as individuals tend to experience more side effects from medication.
- It is costly for both the individual and the healthcare system.
What can you do to avoid polypharmacy?
It is always important to let your health providers know all the medications you are using, prescribed and non-prescribed. Before a new medication is added to your treatment, ask if it is necessary and whether there is another medication that can be stopped. Talk to your pharmacist about medication optimisation.
Your responsibility
- Tell your Doctor or Pharmacist about all medications you are using
- If on multiple medications treat every new symptom as a side effect until proven otherwise.