Addressing the Challenge of Polypharmacy

Alpana Mair (Lead / Corresponding author), Martin Wilson, Tobias Dreischulte

Research output: Contribution to journalArticle

Abstract

Polypharmacy describes the concomitant use of multiple medicines and represents a growing global challenge attributable to aging populations with an increasing prevalence of multimorbidity. Polypharmacy can be appropriate but is problematic when the increased risk of harm from interactions between drugs or between drugs and diseases or the burden of administering and monitoring medicines outweighs plausible benefits. Polypharmacy has a substantial economic impact in service demand and hospitalization as well as a detrimental impact on patients' quality of life. Apart from causing avoidable harm, polypharmacy can also lead to therapeutic failure, with up to 50% of patients who take four or more medications not taking them as prescribed. Guidance is needed to support patients and clinicians in defining and achieving realistic goals of drug treatment, and system change is necessary to aid implementation. This article outlines lessons from two programs that aim to address these challenges: the Scottish polypharmacy guidance on realistic prescribing and the European Union SIMPATHY project.

Original languageEnglish
Pages (from-to)661-681
Number of pages21
JournalAnnual Review of Pharmacology and Toxicology
Volume60
Early online date7 Oct 2019
DOIs
Publication statusPublished - Jan 2020

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Keywords

  • adherence
  • appropriate polypharmacy
  • deprescribing
  • effectiveness
  • medication review
  • patient-centered
  • safety

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