Polypharmacy
Introduction
Different healthcare professionals have different definitions of polypharmacy. Generally, polypharmacy is the use of many different medications at the same time (Lim et al., 2017). However, many professionals agree that the condition becomes polypharmacy when the patient uses a minimum of five different drugs. These drugs include non-prescription, prescription, and over-the-counter (OTC) drugs such as dietary supplements (Lim et al., 2017) The condition is much common among the elderly population (Mansoon et al., 2017).
Risk Factors
Different factors increase the likelihood of an individual suffering from polypharmacy. Such factors include age, use of dietary supplements, and chronic systemic conditions such as gastrointestinal disorders, endocrine disorders, and cardiovascular disorders (Lim et al., 2017).
Results from a study indicate that as people get older, the potential of using multiple drugs concurrently increases (Lim et al., 2017). The reason behind this problem could be the fact that an individual’s immune system grows weaker as they get older. Therefore, the elderly population is more prone to diseases and infections. Also, older individuals have brittle bones, and they are more likely to get injuries even from the slightest of falls. As a result, these individuals may require constant medication to help maintain their health status in old age. Some of these conditions may overlap, resulting in polypharmacy.
It is not uncommon to have individuals suffering from nutritional deficiencies. These individuals require dietary supplements to help meet their bodies’ nutritional requirements. As a result, they are on constant medication in the form of supplements. If they were to receive any more medication for resulting illnesses, they are likely to suffer from polypharmacy because they would be using several medical products at the same time.
Finally, the group of individuals suffering from chronic conditions has a lot of medicinal requirements. Health care professionals usually prescribe several medications to help them manage their conditions. Such medications include pain relievers, anti-depressants, and other therapeutic drugs. Eventually, the individual has a variety of drugs to take regularly, resulting in polypharmacy.
Prevention of Polypharmacy
Health care providers have a critical role in reducing the incidence of polypharmacy among their patients. The first step is by offering counseling sessions to the patients advising them on the adverse effects of polypharmacy and why they should avoid it at all costs. They can encourage the patients to seek regular consultation in case they are uncertain about the number of drugs to use.
Health workers should prioritize offering single medicine types that are a combination of different drugs rather than giving individual medicines to patients. This move would reduce the number of drugs available to the patient, effectively reducing the incidences of polypharmacy. Lastly, health workers need to monitor the patient’s response to medication and withdraw the use of drugs that are not vital for the patient. The patient can continue living healthily without the use of certain medicines, which may not be essential at the time.
Measures by Preceptor
My clinical preceptor developed a system whereby the patients receive printed forms containing all the medications the patient is currently undertaking. Therefore, when the patients come to the clinic, they have to produce the list and have a health worker go through the list with them. They also provide an account of all other medicines they may have used within the period, including over-the-counter drugs and dietary supplements. The health worker analyzes this information to identify the possible risk of polypharmacy and provides the necessary advice.
Conclusion
Polypharmacy is the concurrent use of five or more medications by the same person. The condition is more common in the elderly population due to their weakened immune system. Therefore, health care workers should play their part in ensuring that they reduce incidents of polypharmacy in the community.
References
Lim, L. M., McStea, M., Chung, W. W., Azmi, N. N., Aziz, S. A. A., Alwi, S., … & Rajasuriar, R. (2017). Prevalence, risk factors, and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia. PLoS One, 12(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5342241/
Masnoon, N., Shakib, S., Kalisch-Ellett, L., & Caughey, G. E. (2017). What is polypharmacy? A systematic review of definitions. BMC geriatrics, 17(1), 230. https://link.springer.com/article/10.1186/s12877-017-0621-2