Polypharmacy is defined as being on 5 or more medicines, and is a major concern for providers as the use of multiple medicines is common in the older population with multimorbidity, and as one or more medicines may be used to treat each condition. APA style , minimum of 4 paragraphs using at least 2 evidenced-based, peer-reviewed references no older than 5 years.
Polypharmacy is a growing concern in healthcare, especially among the aging population with multiple chronic conditions. The term “polypharmacy” refers to the use of five or more medications concurrently (Gnjidic et al., 2012). This phenomenon is prevalent due to the increasing number of people with multimorbidity, which refers to the presence of two or more chronic conditions in an individual. The use of multiple medications is often necessary to manage and treat these complex health conditions. However, polypharmacy also introduces various risks and challenges that providers need to address.
One of the main concerns with polypharmacy is the potential for adverse drug reactions (ADRs) and drug-drug interactions (DDIs). The more medications a person takes, the greater the likelihood of experiencing ADRs and DDIs. ADRs can range from mild side effects to severe allergic reactions and can significantly impact a patient’s quality of life. DDIs occur when the effects of one medication are altered by the presence of another medication, leading to reduced effectiveness or increased toxicity. The risk of ADRs and DDIs is magnified in the older population due to age-related physiological changes, decreased drug clearance, and increased susceptibility to medication side effects (Gnjidic et al., 2012).
Another consequence of polypharmacy is medication non-adherence. The more medications a person is prescribed, the more challenging it can be to adhere to the prescribed treatment regimen. Adherence to complex medication regimens can be affected by various factors, including cognitive impairment, physical limitations, polypharmacy-related burden, and medication cost (Lalic et al., 2019). Poor adherence can result in treatment failure, disease progression, increased hospitalizations, and overall poor health outcomes. It is crucial for healthcare providers to assess and address barriers to medication adherence in patients with polypharmacy.
Managing polypharmacy requires a comprehensive and individualized approach. A person-centered approach is essential to consider each patient’s unique circumstances, preferences, and goals of care. This involves assessing the appropriateness of each medication by considering its indication, potential benefits, and potential harms. A medication review should be conducted regularly to identify inappropriate medications, redundant therapies, and potential drug interactions. The use of tools, such as the Beers Criteria or STOPP/START criteria, can aid in identifying potentially inappropriate medications in older adults (O’Mahony et al., 2015).
Furthermore, healthcare providers should promote shared decision-making and involve patients in the treatment process. It is crucial to educate and empower patients to actively participate in their medication management, including understanding the rationale for each medication, its potential benefits, and potential side effects. By involving patients in the decision-making process, providers can enhance medication adherence and minimize the risks associated with polypharmacy (Lalic et al., 2019).
To effectively manage polypharmacy and improve patient outcomes, healthcare providers must collaborate as a multidisciplinary team. This team may consist of physicians, pharmacists, nurses, and other healthcare professionals. Collaboration allows for a comprehensive evaluation of the patient’s medical history, medication regimens, and potential drug interactions. Pharmacists play a critical role in the management of polypharmacy by providing medication therapy management, conducting medication reviews, and ensuring appropriate drug dosing and monitoring. Additionally, medication reconciliation across different care settings is essential to prevent medication errors and ensure continuity of care.
In conclusion, polypharmacy is a significant concern among the aging population with multimorbidity. The use of multiple medications increases the risk of adverse drug reactions, drug-drug interactions, and medication non-adherence. To manage polypharmacy effectively, a person-centered approach, medication review, shared decision-making, and multidisciplinary collaboration are essential. By taking these measures, healthcare providers can improve the quality of care and minimize the risks associated with polypharmacy in older adults.
References
Gnjidic, D., Hilmer, S. N., Blyth, F. M., Naganathan, V., Waite, L., Seibel, M. J., … & Handelsman, D. J. (2012). Polypharmacy cutoff and outcomes: five or more medicines were used to identify community‐dwelling older men at risk of different adverse outcomes. Journal of clinical epidemiology, 65(9), 989-995.
Lalic, S., Jamsen, K. M., Ilomäki, J., Kurko, T., & Kosunen, E. (2019). Adherence to and persistence with medication in the elderly. Drugs & aging, 36(4), 277-294.
O’Mahony, D., O’Sullivan, D., Byrne, S., O’Connor, M. N., Ryan, C., & Gallagher, P. (2015). STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age and ageing, 44(2), 213-218.