Polypharmacy – even the word has a negative connotation

Nina Barnett

Professor Nina Barnett, Consultant Pharmacist for Older People, Medicines Use and Safety Team, NHS Specialist Pharmacy Service

As clinicians we think of polypharmacy as patients being prescribed too many medicines, some of which are at best redundant and at worst cause patient harm. It is easy for us to take a clinician-centred, negative view of the prescribing of multiple medicines because of our awareness of the risks associated with polypharmacy, but I want challenge this thinking and reframe our view of polypharmacy, so we think about it from a patient perspective.

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How much is polypharmacy a necessary evil?

MartinDuerden

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 It was clear from our review that this high minded perspective of polypharmacy was no longer valid.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’.

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Pharmacy services for the “oldest” old

Maria Veart 150x150By Maria Veart MRPharmS, Research & Clinical Pharmacist, Hospital@Home, NHS Fife

Given the choice I imagine that most elderly patients would prefer to stay in the comfort of their own home and be treated there when ill, with friends and family close by, rather than be admitted to hospital. Now, thanks to a project in NHS Fife 80% of elderly patients in this area are able to receive hospital-like treatments in their own home. Read more Pharmacy services for the “oldest” old