Polypharmacy refers to the simultaneous use of multiple medications, specifically five or more medications daily. These medications can include prescribed drugs, over-the-counter medications, or supplements necessary for managing chronic health conditions or multiple chronic conditions.
The elderly population, with their multiple chronic conditions, is the primary demographic affected by polypharmacy. Managing several medications daily can be overwhelming, especially for older adults. In many instances, inappropriate polypharmacy can be addressed through effective communication between health professionals. However, if you or a loved one is experiencing excessive polypharmacy, it's important to educate yourself about what it entails and the steps you can take to avoid adverse drug events.
Understanding Polypharmacy: Managing Multiple Medications
While according to the World Health Organization, the scientific community does not have a universal definition for polypharmacy, it generally involves the use of multiple medications, often prescribed by different providers, for multiple chronic conditions. The term is typically used for individuals who take at least five different medications daily, with some medications taken two or three times daily.
In some cases, these medications may not be directly necessary for treating a medical condition but may help alleviate symptoms. Moreover, different doctors may prescribe several medications for the same symptoms, not realizing the patient is already being treated. This can lead to potentially inappropriate medication use and increased risk of adverse effects.
In 2018, 39% of seniors were involved in polypharmacy. As one's age increases, they become more susceptible to polypharmacy due to an increased risk of various health conditions, such as heart disease, high blood pressure, and other chronic issues requiring medication.
Why Does Polypharmacy Occur?
Polypharmacy often occurs when patients are treated by more than one doctor for complex diseases, and there is a lack of communication between providers. Patients typically see multiple specialists for treatment of chronic conditions. Without proper communication about the patient's medical history and current medications, inappropriate prescribing can occur, leading to the use of potentially inappropriate medications, adverse drug-drug interactions or medication errors.
This oversight can happen easily without efficient record management by the providers and the patient's awareness of their regular medication regimen. Even with the advent of electronic health records and online patient portals, one wrong click or one missed email update can result in a less appropriate polypharmacy.
With as much as 12% of the U.S. population experiencing polypharmacy, it becomes the responsibility of patients to ensure they are not victims of these oversights.
The Risks Associated with Polypharmacy
Polypharmacy becomes risky when medications are poorly managed at home. Elderly patients often lay out their prescription bottles on the counter as a reminder to take them, not utilizing medication management systems. As a result, it's not uncommon for seniors to make mistakes when taking their prescriptions, leading to medication errors.
Even with a reminder note or a weekly pill case, many older patients tend to forget to take their medication, which can result in serious consequences beyond just missing a dose. In other scenarios, people may even ignore the instructions on the bottles, taking all of their medications at the same time with or without food in efforts to consolidate their routine and make the process easier.
Adverse Drug Reactions
With polypharmacy, potentially dangerous drug interactions can also go unnoticed. Such scenarios are especially likely when the provider doesn’t make enough of an effort to communicate with the patient about medications being prescribed. When this happens, medications prescribed may be treating the symptoms of the same condition, when just one prescription would have been enough.
When mixing the wrong drugs or taking too much of one medication, dangerous or even fatal side effects can occur. Some drug reactions may also cause long-term internal damage to the patient’s liver or kidneys without presenting visible symptoms, making it all the more important to be aware of the risks involved in polypharmacy.