What Is Polypharmacy?
Polypharmacy Generally Refers To The Regular Use Of Five Or More Medicines. It Is Common Among Older Adults And People With Multiple Chronic Illnesses. However, Taking Five Or More Medicines Does Not Automatically Mean That Treatment Is Inappropriate. Some Patients Need Several Medicines To Control Their Conditions And Prevent Complications. The Real Concern Is Unnecessary, Ineffective, Duplicative Or Potentially Harmful Medication Use.
Why Do People End Up Taking Too Many Medicines?
Common Reasons Include: Consulting Several Doctors Without Sharing A Complete Medication List.
Continuing Medicines Prescribed For A Temporary Illness Long After They Are Needed. Taking Medicines Recommended By Friends, Relatives Or Pharmacists Without Appropriate Review. Using Over-the-counter Painkillers, Acidity Medicines, Supplements Or Herbal Products Alongside Prescribed Drugs. Taking Multiple Products Containing The Same Active Ingredient. A Medicine That Was Appropriate Several Years Ago May No Longer Be Necessary Or Suitable As A Person’s Health Changes.
Are Medicines Prescribed By Different Doctors A Problem?
They Can Be, Particularly When The Doctors Do Not Have A Complete Record Of The Patient’s Treatment. For Example, Two Specialists May Unknowingly Prescribe Medicines From The Same Class, Or One Doctor May Prescribe A Medicine That Interacts With Another Prescribed Elsewhere.
Patients Should Maintain A Current Medication List And Share It At Every Consultation.
What Can Patients And Families Do To Prevent Medication-related Harm?
Keep An Updated List Of Medicines With Their Names, Doses, Timing And Reasons For Use. Carry It To Every Medical Appointment. Use A Pill Organiser If Appropriate, And Ask For Written Instructions When Treatment Changes. Do Not Share Medicines With Others, Use Leftover Antibiotics Without Medical Advice Or Add Supplements Without Checking For Interactions. Report New Symptoms After A Medicine Is Started, And Ask The Doctor Or Pharmacist Whenever Instructions Are Unclear.
What Are The Dangers Of Taking Multiple Medicines?
The Risks Depend On The Medicines, Their Doses, The Patient’s Health And How They Are Combined. Potential Problems Include: Dizziness, Drowsiness And Falls. Low Blood Pressure And Fainting. Low Blood Glucose, Particularly With Certain Diabetes Medicines. Kidney Or Liver Injuy. Gastrointestinal Bleeding. Confusion And Impaired Concentration. Drug Interactions
And Difficulty Following Complicated Schedules. The Risk Is Often Greater In Older Adults And People With Impaired Kidney Or Liver Function.
Can Medicines Be Stopped Abruptly If They Are No Longer Needed?
No. Some Medicines Must Be Reduced Gradually To Avoid Withdrawal Symptoms Or A Worsening Of The Underlying Condition. For Example, Abruptly Stopping Certain Antidepressants, Long-term Corticosteroids Or Some Beta-blockers Can Cause Significant Problems.
What Is Deprescribing?
Deprescribing Is The Planned, Supervised Process Of Reducing The Dose Or Stopping A Medicine When Its Potential Harms Outweigh Its Benefits, Or When It Is No Longer Needed. It May Be Considered When: A Medicine Has No Clear Ongoing Indication. Two Medicines Unnecessarily Duplicate Each Other’s Effects. Side Effects Outweigh The Expected Benefits. The Patient’s Kidney Function Or Overall Health Has Changed. Treatment Goals Or Preferences Have Changed. A Medicine Prescribed For A Short Duration Has Continued Indefinitely. Deprescribing Is Not The Same As Abandoning Treatment. It Is A Structured Approach To Making Treatment Safer And More Appropriate.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.
