The simultaneous use of multiple medications by a single patient for one or more conditions is called polypharmacy. Polypharmacy increases the risk of adverse drug events due to use of many or unnecessary medicines at dosages or frequencies higher than therapeutically essential. Additional drugs are prescribed when adverse reactions misinterpreted as a medical condition. Drug use increases with age, because older people have higher rates of chronic illness. They are more likely to be taking multiple drugs to treat the diseases. Not only age but also other factors such as hospitalisation, severity of illnesses, number of physicians seen and number of pharmacies used are associated with the uses of multiple medications by a single patient.

Problems associated with polypharmacy

Generally, the functions of some vital body organs are decreased in aged people and these organs may be affected when people are taking multiple drugs. They not only affect the body but also cause drug toxicity and interaction between the different drugs. For example some medications can cause renal dysfunction and others may cause liver disease or upsetstomach.

Reasons for polypharmacy

·               Patient faces multiple diseases and contact with different physicians for their medical problems

·               Poor communication between the patient and physician

·               Use of repeated prescriptions

Managing the polypharmacy

·               Physicians should be careful during prescribing drugs. They should avoid prescribing for minor and non-specific diseases.

·               Physicians should monitor the adverse effects, drug-drug interaction, dose and dosage regimen while patient is taking multiple medications.

·               Physicians should ask the patient to bring in all their prescribed and non-prescribed medications or previous prescriptions while consulting.

·               Physicians and pharmacists can advise the patient to lead a healthy life to avoid some critical diseases like diabetes and cardiac diseases. Also counsel the patients how healthy lifestyle reduces the need of unnecessary medications.

·               If patient wants to change the medication regimen s/he should discuss with health care providers.

·               Pharmacist/nurse should verify that the patient understands about taking the drug properly.

When a patient is discharged from the hospital polypharmacy occur due to poor communication with health care providers. Patients should contact with his/her health care providers for their own benefits and improve the quality of life. Physicians, pharmacists and nurses can play a vital role for prevention of and managing the polypharmacy.

If the adverse reactions and side-effects are controlled, older people would get enough benefit from today's medicines. By monitoring the patients and regular medication reviews, polypharmacy can be managed. Ultimately drugs related adverse reactions and side-effects can be controlled.

The writer is a lecturer of Department of Pharmacy, Primeasia University. E-mail: amit.pharmacy30@gmail.com