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Polypharmacy

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Acute

What is Polypharmacy ?

Polypharmacy refers to the use of multiple medications by a patient, typically five or more, often seen in elderly individuals who have multiple chronic conditions. While polypharmacy can be necessary for managing multiple health issues, it also increases the risk of adverse drug interactions, medication errors, and complications.

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Symptoms

  • Increased risk of side effects
  • Dizziness, confusion, or cognitive impairment
  • Falls and fractures
  • Unintended weight loss or poor appetite

Complications

  • Drug-drug interactions Medications may interfere with each other’s effects, leading to reduced efficacy or increased toxicity.
  • Adverse drug reactions Older adults are more vulnerable to the side effects of medications.
  • Non-adherence Complex medication regimens can lead to missed doses or improper use.
  • Cognitive decline and frailty Certain medications, like sedatives, can exacerbate cognitive decline in the elderly.

Causes

  • Multiple chronic conditions (e.g., hypertension, diabetes, arthritis) require treatment
  • Lack of communication between different healthcare providers
  • Self-medication or over-the-counter drug use
  • Changing medical conditions that require new prescriptions without reviewing existing medications

Prevention

  • Medication review Regular evaluation of the patient’s medication list by healthcare providers to ensure that all prescriptions are necessary and appropriate.
  • Deprescribing The process of gradually reducing or stopping unnecessary medications.
  • Patient education Ensuring patients understand the purpose and proper use of their medications.
  • Single healthcare provider coordination Reducing the number of healthcare professionals prescribing medications for a patient can help prevent conflicts or duplications.

Risk factor

  • Advanced age
  • Chronic health conditions requiring long-term treatment
  • Multiple healthcare providers or specialists
  • Poor communication between patients and their healthcare team
  • Cognitive impairment or lack of family support

Management

  • Medication review by a geriatrician to evaluate the necessity of each medication.
  • Deprescribing Discontinuing non-essential medications to reduce the burden of polypharmacy.
  • Simplification of regimens Streamlining medication schedules and doses to improve adherence.
  • Monitoring for side effects Regular assessment of medication effects, adjusting doses, or changing medications as needed.
  • Patient and caregiver education Empowering patients and caregivers with knowledge on the importance of medication management.

How is it diagnosed?

How is it diagnosed?
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