Polypharmacy: An Overview of The Definition, Terminology, And Implications

Abstract

Background: Polypharmacy, the concurrent use of multiple medications, has long been recognized as a major concern, particularly for older adults. Initially defined by excessive drug use, the concept has evolved to address unnecessary or inappropriate medication use. Polypharmacy is linked to heightened risks of adverse outcomes such as falls, frailty, disability, and increased mortality, particularly in older adults with chronic diseases. The World Health Organization stresses minimizing inappropriate polypharmacy while ensuring medications are evidence-based and appropriate for individual patients.

Aim: This article aims to provide a comprehensive overview of polypharmacy, exploring its definition, implications, and evidence-based strategies to mitigate its risks, particularly in older adults.

Methods: The article synthesizes contemporary data on polypharmacy and its impacts, focusing on evidence-based practices and the importance of identifying appropriate versus inappropriate polypharmacy. It also discusses common issues such as multi-morbidity, adverse drug effects, drug interactions, non-adherence, prescribing cascades, and the role of over-the-counter medications.

Results: Polypharmacy is increasingly common, especially in elderly populations, due to multi-morbidity and aging-related physiological changes. The use of multiple medications raises the risk of adverse drug effects, interactions, and non-adherence. Inappropriate polypharmacy often results from lack of clinical reasoning and is linked to detrimental outcomes. Effective management through regular medication reviews, deprescribing, and patient education can significantly reduce the risks.

Conclusion: Polypharmacy presents both challenges and opportunities in clinical practice. When appropriately managed, polypharmacy can prevent unplanned hospital admissions, but inappropriate prescribing practices increase the risk of adverse outcomes. A patient-centered, interdisciplinary approach to medication management, along with regular reviews and evidence-based prescribing, is essential for optimizing therapeutic outcomes and minimizing harm.