The proportion of the global population over 65 years old will increase from 11 per cent in 2010 to 22 per cent by 2050. In Europe, advances in healthcare, education and socioeconomic circumstances mean that in most countries people can now expect to live beyond 80 years of age. However, evidence shows that the average healthy life years (HLY) for EU citizens is only 61 years, meaning that many people are living for around 20 years in sub-optimal health. 

Despite this, most medical research, guidance and contractual agreements (such as pay-for-performance initiatives) are focused on the management of single disease states. In these patients, individually treating each condition inevitably leads to the use of multiple medications (polypharmacy), the risks and benefits of which are largely unproven and often unpredictable.

It is important to note that polypharmacy is not inappropriate per se and is often beneficial (Scottish Government Polypharmacy Model of Care Group, 2015). For example, effective secondary prevention of myocardial infarction requires the use of at least four different classes of drugs (antiplatelets, statins, angiotensin-converting enzyme inhibitors and beta-blockers). 

However, polypharmacy becomes inappropriate when the risks of multiple medications begin to outweigh their potential benefits for an individual patient. ‘Deprescribing’ has become a buzzword in the NHS and this module will put it in context and help understanding of what it means for patients and pharmacists.