Polypharmacy is associated with the concurrent use of different medications to either treat the same condition or treat multiple disease conditions. It includes the use of many drugs on a daily basis with a likelihood that all the medicines prescribed may not be clinically relevant. According to different schools of thought, the number of medications defined as polypharmacy could range from 2 drugs to more.
Polypharmacy is common in Old people with multiple disease conditions, in such cases, the prescriber has no option than to prescribed multiple drugs. Polypharmacy is a common problem and could potentially be dangerous. Risk factors that contribute to polypharmacy is a patient receiving a prescription from multiple physicians and purchasing medication from different drug source.
CONCERNS ABOUT POLYPHARMACY
Drug-drug/ drug-food interactions may exist when the drugs taken at a time are too much. These may potentially influence the activity of drugs and if it negatively affects the body it produces adverse reactions. The patient may not be able to remember the counsel given as regards the usage of the drugs. “Take one tablet on an empty stomach, take this tablet after food, take this one immediately you wake up, take this one at bedtime, do not take drug A and B together ” these instructions become too much that there might be a tendency to miss it up. Another disadvantage’s that it could decrease the patient’s adherence to medication. The pill burden is too much and often might intentionally skip a dose. I have had patients who complained if they must take all their antihypertensives daily. The thought of swallowing maybe 5 big, bitter tablets every day could be discouraging. Lastly, the monetary burden of polypharmacy is a source of concern. little income now spent on purchasing multiple drugs may affect adherence too.
Taking multiple drugs at the same time may be inevitable sometimes but not always necessary in some circumstances. For example, a popular practice is the use of different classes of NSAIDs at the time because of a minor joint ache. The Patient is given paracetamol,felvin, diclofenac, and ibuprofen to take at the same time to relieve pain. Combining these classes together increases the patient’s risk of developing peptic ulcer disease. The mentality of the more the number of drugs the better result you get is always not the ideal thing.
How can patients and caregivers help? Polypharmacy in some circumstances is inevitable. People with multiple disease conditions need to be managed with different drugs. Hypertensive, diabetic patients are usually treated with more than one drug. The patient can help in this case by reporting any side effects to the physician or pharmacist who then resolves the therapy problem. Doctors should also have the medication history list of their patients so they know what to prescribe and what not to prescribe. Pharmacists should also be able to properly counsel the patient about the drug prescribed before dispensing it. Pharmacists should also know the patient’s medical and medication history as this would get them better informed about the patient. The patient can be asked to bring all their drugs on their next hospital/ pharmacy visits, then their drugs can be reviewed, and if there is a potential therapy problem it can be resolved.
If polypharmacy issues are managed properly, Patients would become healthier, less hospital emergency, and eventually reduced health care costs.
pharmMind 