By Dr Martin Duerden, a GP in North Wales and Clinical Senior Lecturer at Bangor University
A few years ago, I and some GP colleagues – Tony Avery from Nottingham University, and Rupert Payne from Cambridge University – were asked to do a review of polypharmacy by the King’s Fund. Polypharmacy had always been looked on disparagingly through my training in medicine and my subsequent work as a GP. It was clear from our review that this high minded perspective of polypharmacy was no longer valid.
Polypharmacy has become common place and the stark evidence is that we now have three times more people taking ten-or-more drugs than was the case in the late 1990s. The reasons for this are complex; many more people take preventative drugs for things like high blood pressure and lipid-lowering; we have a plethora of guidelines urging us to use treatments; and there are an increasing number of drugs available. Perhaps the biggest issue now and in the future is the shear number of people in middle age who are getting older and frailer and carrying many diseases into old age – the so-called ‘multimorbidity challenge’.