From Wikipedia,
the free encyclopedia
The term polypharmacy
generally refers to the use of
multiple
medications by a patient. The
term is used when too many forms
of medication are used by a
patient, more
drugs are prescribed than
clinically warranted,[1]
or even when all prescribed
medications are clinically
indicated but there are too many
pills to take ("pill
burden"). The common result of
polypharmacy is increased
adverse drug reactions and
higher costs.
At risk demographic groups
Patients at greatest risk of
polypharmacy consequences include
the
elderly,
psychiatric patients, patients
taking five or more drugs
concurrently, those with multiple
physicians and
pharmacies, recently
hospitalized patients, individuals
with concurrent
comorbidities, and those with
impaired vision or dexterity.
Adverse reactions and
interactions
Every medication has potential
adverse side-effects. With every
drug added, there is an additive
risk of side-effects.
Many medications have potential
interactions with other
substances. As a new drug is
prescribed, the risk of
interactions increases
exponentially. Doctors and
pharmacists aim to avoid
prescribing medications that
interact; often, adjustments in
the dose of medications need to be
made to avoid interactions, such
as with
warfarin.
Solutions
Zarowitz et al[2]
studied clinical pharmacists
performing drug therapy reviews
and the teaching of physicians and
their patients about drug safety
and polypharmacy, as well as
collaborating with physicians and
patients to correct polypharmacy
problems. This led to a marked
improvement in interactions and
cost. Similar programs are likely
to reduce the potentially
deleterious consequences of
polypharmacy. Such programs hinge
upon patients and doctors
informing pharmacists of other
medications being prescribed, as
well as herbal, over-the-counter
substances and supplements that
occasionally interfere with
prescription-only medication.
References
-
↑ Fulton MM,
Allen ER. Polypharmacy in the
elderly: a literature review.
J Am Acad Nurse Pract
2005;17:123-32.
PMID 15819637.
-
↑ Zarowitz BJ,
Stebelsky LA, Muma BK, Romain
TM, Peterson EL. Reduction of
high-risk polypharmacy drug
combinations in patients in a
managed care setting.
Pharmacotherapy
2005;25:1636-45.
PMID 16232025.