Polypharmacy

Definition

Polypharmacy describes the use of multiple drugs by a single patient to treat one or more conditions. It is most common among elderly patients, ages 65 and over. It is estimated to cause 100,000 deaths per year.

Alternate names

Multiple medications

Causes, incidence and risk factors

Polypharmacy can be caused by a variety of factors including:

• Self-medicating without an accurate understanding of effects and reactions
• Patients being prescribed multiple medications by health professionals who are not aware of other parties involved
• Lack of communication and coordination between physician, nurse, and pharmacist
• An aging population with an increased number of treatment options

Signs and symptoms

Possible symptoms of polypharmacy include:

• Loss of appetite
• Falls
• Confusion
• Weakness
• Tremors
• Dizziness
• Anxiety
• Depression
• Tiredness or decreased alertness

Tests & Treatments

Physicians should be aware of all medications the patient is taking and potential side effects for each. Often, physicians will intervene by simplifying medications and lessening the amount a patient has to take. Taking multiple medications may cause more harm than good for patients, especially as they get older.

Support groups

Several online support groups have been formed:

• http://www.mdjunction.com/forums/aging-discussions/introductions-personal-stories/150215-polypharmacy
• https://www.caring.com/articles/polypharmacy-seniors-avoiding-drug-interactions
• https://www.agingcare.com/articles/polypharmacy-in-elderly-155512.htm

Expectations (prognosis)

The potential for not taking medications as directed increases with the number of medications prescribed.

The risk of falls increases with the number of medications taken, with those taking four or more medications at the greatest risk of falling.

When to call your health care provider

You should call your health care provider if you begin to feel defeated by the medications that have been prescribed. Malnourishment, urinary incontinence, falls and cognitive impairment are also areas of concern.

Prevention

It is best to encourage open communication between the pharmacist, nurse, and physician. Patients should keep a detailed medication history that includes all medications, the schedule of treatment and the reason or indication for each medication. Sometimes, medications can be taken less frequently or at a different time of the day.

References/Citations

Golchin, N., Frank, S. H., Vince, A., Isham, L., & Meropol, S. B. (2015). Polypharmacy in the elderly. Journal of research in pharmacy practice, 4(2), 85.

Hammond, T., & Wilson, A. (2013). Polypharmacy and falls in the elderly: a literature review. Nursing and midwifery studies, 2(2), 171-175.