Polypharmacy is a relative term that has been used for years in the medical world to describe the use of multiple medications in an individual. It is relative because there is no set number that defines polypharmacy. There have been countless clinical studies looking at polypharmacy, all with slightly different definitions and with cut-offs ranging from 4 to 15.
One thing that can be agreed on is that, as the number of medications you take increases, so does the risk of adverse events, side effects, interactions and potentially inappropriate prescribing.
Polypharmacy is all-encompassing and includes not only prescription drugs but also non-prescription drugs such as over-the-counter medicines and natural or herbal medicines because they all come with risks associated with taking them either alone or in combination with other medications.
People at risk of polypharmacy are people with multiple medical conditions, people who see multiple doctors or specialists and people who take non-prescription or over-the-counter medications.
Side effects of medications can sometimes closely resemble symptoms of a disease and can be misdiagnosed as such. This can lead to unnecessary and inappropriate prescribing adding to the polypharmacy burden.
There risks are not only associated with certain combinations of medicines – being on a large number or medications with complex regimens can increase the risk of errors and can interfere with the patient actually taking their medications. If someone finds taking their medications onerous, they may become selective about what medications they take, which may be just as bad.
People taking multiple medications warrant a medicine review to see if any of their medications could potentially be reduced or modified, withdrawn or ceased altogether. Sometimes a trial off a medication can help determine whether they are really necessary or if they are potentially causing other unwanted effects.
Granted, medications are prescribed for a reason, so if the purpose for each medication is justified and no serious interactions are identified, then it may actually constitute best care for that patient.
It is important to remember that people’s conditions can change over time, as well as their situation, so a medication that was prescribed for a particular purpose may no longer be useful or the risk of taking it now outweighs any potential benefits.