Premium
Appropriate and inappropriate polypharmacy—Choosing the right strategy
Author(s) -
Hughes Carmel
Publication year - 2021
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.14589
Subject(s) - polypharmacy , context (archaeology) , medicine , harm , medical prescription , deprescribing , psychological intervention , intensive care medicine , alternative medicine , family medicine , medical emergency , psychiatry , nursing , psychology , social psychology , paleontology , pathology , biology
Prescribing of medicines is one of the most common and important healthcare interventions that will be experienced by most patients, particularly those who are old, and have multiple medical conditions. The prescribing of multiple medicines has been described as polypharmacy, but there is no precise or accepted definition of this term. Numerical thresholds have often been used, but increasingly, this is not seen as helpful. Gurwitz has stated that the use of larger numbers of medicines would always be a key part in the medical management of older (American) patients, and stated that polypharmacy could be a 'new paradigm for quality drug therapy'. Increasingly, there has been a move to differentiating between inappropriate polypharmacy (too many medicine) and appropriate polypharmacy (many medicines), with the legitimate goal of managing multiple medical conditions in the same patient. So how do we reach the optimal balance between the prescribing of many medicines (appropriate polypharmacy) and the prescribing of too any medicines (inappropriate polypharmacy) and what strategies should we adopt?