Assignment: Discussion on Polypharmacy

Assignment: Discussion on Polypharmacy

Assignment: Discussion on Polypharmacy

Polypharmacy is a common concern, especially in the elderly. · Discuss three risk factors for polypharmacy. Explain the rationale for why each listed item is a risk factor. · Discuss three action steps you can take in your clinical practice to prevent polypharmacy. · In your clinical practice have you seen providers address polypharmacy? If so, how?

Polypharmacy is the concurrent use of multiple  by a . Polypharmacy is most common in the , affecting about 40% of older adults living in their own homes. About 21% of adults with  are also exposed to polypharmacy.Polypharmacy is not necessarily ill-advised, but in many instances can lead to negative outcomes or poor treatment effectiveness, often being  or presenting . Therefore,  consider it a situation that requires monitoring and review to validate whether all of the medications are still necessary. Concerns about polypharmacy include increased , , , and higher costs. Polypharmacy is often  a decreased , including decreased  and .

The definition of polypharmacy is still debated. Definitions have ranged from two medications at a time to 18, or to more medications than clinically necessary. Five or more concurrent regular medications appears to be the most common definition. Despite the uncertainty around a definition, experts generally agree on the magnitude, potential for harm and potential for reduction in medication regimens for older people.

Whether or not the advantages of polypharmacy (over monotherapy) outweigh the disadvantages or risks depends upon the particular combination and diagnosis involved in any given case. The use of multiple drugs, even in fairly straightforward illnesses, is not an indicator of poor treatment and is not necessarily . Moreover, it is well accepted in  that it is impossible to accurately predict the side effects or clinical effects of a combination of drugs without studying that particular combination of drugs in test subjects. Knowledge of the pharmacologic profiles of the individual drugs in question does not assure accurate prediction of the side effects of combinations of those drugs; and effects also vary among individuals because of -specific . Therefore, deciding whether and how to reduce a list of medications () is often not simple and requires the experience and judgment of a practicing physician. However, such thoughtful and wise review is an ideal that too often does not happen, owing to problems such as poorly handled  (poor continuity of care, usually because of ), overworked physicians, and .

Polypharmacy continues to grow in importance because of . Many countries are experiencing a fast growth of the older population, 65 years and older.This growth is a result of the  generation getting older and an increased  as a result of ongoing improvement in health care services worldwide