Not a new concept:
“it is an art of no little importance to administer medicines properly: but, it is an art of much greater and more difficult acquisition to know when to suspend or altogether to omit them”. Philippe Pinel, Psychiatrist (1745-1826)
Polypharmacy is usually defined as when a patient takes four or medications and this number can vary depending on the reference source and which part of the world you are in.
The term polypharmacy usually invokes thoughts of something that needs to be tackled by healthcare professionals. However, in certain cases, such as in secondary prevention of myocardial infarction, four classes of medications are needed (antiplatelets, beta blockers, ACE inhibitors and statins).
Increasingly, the concept of deprescribing is gaining traction and can be described simply as inappropriate polypharmacy.
Points to consider:
– Is the medication appropriately indicated?
– Is the dose appropriate to achieve the therapeutic objectives it is intended to?
– Have other considerations been taken into account e.g. age/renal function etc?
– Due to the combination of medications, is the patient at risk of Adverse Drug Reactions (ADRs)?
Lots to consider when reviewing medicines and there are lots of resources available to help.