Reducing Inappropriate Polypharmacy through Deprescribing
Polypharmacy refers to the simultaneous use of multiple medications. It can lead to risks such as drug interactions, increased side effects, medication non-adherence, and cognitive impairment. Learn how to reduce these risks through minimization of prescriptions in ECRI’s white paper, Reducing Inappropriate Polypharmacy through Deprescribing.
Overview
As a common practice of using multiple medications by a single patient, polypharmacy typically involves the regular consumption of five or more drugs. Older adults are especially vulnerable to polypharmacy due to the high rates of having multiple chronic conditions that require treatment with multiple medications. The prevalence of polypharmacy among older adults in community settings varies widely, with multimorbidity and polypharmacy rates ranging from 5% to 91% and 3% to 87%, respectively.
While there may be legitimate reasons for polypharmacy based on a patient's medical profile, it is essential to carefully assess whether the prescribed medications are appropriate and not excessive or inadequate. Older adults often receive care from multiple healthcare providers in different settings, increasing the likelihood of communication breakdowns and coordination issues. Elderly individuals are more prone to experiencing side effects and adverse drug events due to age-related changes in how their bodies process and respond to medications. These side effects can lead to inappropriate polypharmacy through prescribing cascades, where new medications are prescribed to treat mistaken ADEs as new medical conditions instead of discontinuing problematic drugs. Fluctuations in functional, nutritional, psychological, cognitive health, and social support status can further complicate the issue, creating a dangerous cycle of inappropriate polypharmacy with serious risks to patient safety.