Have you ever taken a rather large cocktail of medications to treat one disease or condition? This use of multiple medications – especially at the same time – is called Polypharmacy. It’s loosely defined as the use of five or more regular medications, or it can refer to excessive or unnecessary use of medication.
Polypharmacy has given rise to concern about greater risks of dangerous side-effects, medication drug interactions, and high costs to the patient. It is also often associated with a deceased mobility, decreased quality of life and cognition.
Whether or not polypharmacy poses a risk depends on the specific diagnosis and combination of medicines in any given case, as some conditions involve more than one drug. An example could be treatment for the first year after a heart attack – this could include: a statin, an ACEI inhibitor, a beta-blocker, aspirin, paracetamol and an anti-depressant.
Some examples of inappropriate polypharmacy might be:
- elderly patients
- psychiatric patients
- patients taking five or more drugs at the same time
- patients with more than one doctor and pharmacy
- recently hospitalised patients
- patients who may not be able to follow complex dosage instructions
- patients with impaired vision or dexterity
Pill burden
Pill burden is a term that refers to the number of pills, capsules or tablets that a patient takes on a regular basis. However, it includes issues like storage, organising, remembering when to take each medication and being aware of side effects and possible drug interactions.
High pill burden might mean that a patient doesn’t take all his/her medication at the right time, or regularly. If patients skip doses, they might also take double doses, and this, in turn, can lead to harmful side effects or drug interactions. High pill burden has also been associated with an increased risk of hospitalisation and pill burden is a source of dissatisfaction for many patients.
High pill burden is commonly associated with anti-retroviral drug regimens to control HIV, but it applies to other conditions, such as adults with multiple chronic conditions such as diabetes, hypertension, high cholesterol, osteoporosis, constipation, and clinical depression can often be prescribed more than a dozen different medications daily. The adverse reactions of these combinations of drugs are not reliably predictable.
Manage the risks
If you have been prescribed several medications be sure to label each and follow the instructions carefully, use one pharmacy so that they can advise you on side-effects, keep a list of your medications with you, and make use of a pill organiser.
Sources: JFP Online, Pharmacy Times