Summary
Polypharmacy becomes a problem when it is inappropriate. Pharmacists can identify potential harm when people present with their repeat prescriptions or look to buy OTC medicines to counter any side-effects. These patients would benefit from a medication review and should be referred if they have not had one recently.
Any medication review should be undertaken using a patient-centred structured approach. The 7-step process outlined in the Scottish Government polypharmacy guidance begins by asking the patient – “What matters to you?”. Helping patients to understand the benefits and harms of medication is important at the point of dispensing and as patients transition across care settings.
There are points across the health and care system where errors can occur and where community pharmacists can support patients with their medication and help tackle inappropriate polypharmacy.
Reflective exercise
Using the polypharmacy 'sick day rules' guidance, consider what medicines your patients take that are high risk and how you could raise the issue with them. What advice would you give if they become ill?
Further resources:
- Mair A, Wilson M, Dreischulte T. 2020. Addressing the challenge of polypharmacy. Annual Review of Pharmacology and Toxicology 2020 60:1, 661-681.
- Mair A. 2019. Medication safety in polypharmacy, Third Global Patient Safety Challenge. World Health Organization, Geneva
- Mair A, Fernandez-Limos F, Alonso A, Harrison C, Hurding S et al. 2017. Polypharmacy management by 2030: a patient safety challenge. SIMPATHY Consort. Coimbra.
- Scottish Government Polypharmacy Model Care Group. 2018. Polypharmacy guidance: realistic prescribing. Scottish Government, Edinburgh. 3rd ed.