Polypharmacy
Polypharmacy is defined as "the use of multiple drugs administered to the same patient, most commonly seen in elderly patients. It includes also the administration of excessive medication."[1] Polypharmacy hinders patient compliance with medications and may increase drug-related side effects and adverse reactionss[2].
Taking 4 or more prescriptions daily is more common among low income patients according to one survey.[3] This occurs in 32% of patients with household income below $25,000; whereas this occurs in 12% of those with household income above $75,000.
Using 11 or more chronic medications is a risk factor for drug toxicity.[4]
Combining multiple medications into a single 'polypill' may help patients.[5]
However, taking "three drugs at half standard dose in combination" may be better than one drug at standard dose according to a systematic review.[6]
Reducing polypharmacy
Matching patients' medical problems and their medicines may identify unneeded or low priority drugs that can be discontinued.[7]
Delaying antibiotics for 48 hours while waiting on improvement of respiratory tract infections[8][9] or cystitis[10] may reduce antibiotic usage and reconsultation; however, this strategy may reduce patient satisfaction.
References
- ↑ National Library of Medicine. Polypharmacy. Retrieved on 2007-12-15.
- ↑ Muir AJ, Sanders LL, Wilkinson WE, Schmader K (2001). "Reducing medication regimen complexity: a controlled trial". J Gen Intern Med 16 (2): 77–82. DOI:10.1046/j.1525-1497.2001.016002077.x. PMID 11251757. Research Blogging. Full text at PubMed Central
- ↑ USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: the public on prescription drugs and pharmaceutical companies - kaiser family foundation. Retrieved March 10, 2008, from http://www.kff.org/kaiserpolls/pomr030408pkg.cfm.
- ↑ Guthrie B, McCowan C, Davey P, Simpson CR, Dreischulte T, Barnett K (2011). "High risk prescribing in primary care patients particularly vulnerable to adverse drug events: cross sectional population database analysis in Scottish general practice.". BMJ 342: d3514. DOI:10.1136/bmj.d3514. PMID 21693525. Research Blogging.
- ↑ "Effects of a polypill (Polycap) on risk factors in middle-aged individuals without cardiovascular disease (TIPS): a phase II, double-blind, randomised trial". The Lancet In Press, Corrected Proof. DOI:10.1016/S0140-6736(09)60611-5. ISSN 0140-6736. Retrieved on 2009-03-31. Research Blogging.
- ↑ Law MR, Morris JK, Wald NJ (2009). "Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies". BMJ 338: b1665. PMID 19454737. PMC 2684577. [e]
- ↑ Steinman MA, Hanlon JT (2010). "Managing medications in clinically complex elders: "There's got to be a happy medium".". JAMA 304 (14): 1592-601. DOI:10.1001/jama.2010.1482. PMID 20940385. Research Blogging.
- ↑ Spurling G, Del Mar C, Dooley L, Foxlee R (2007). "Delayed antibiotics for respiratory infections". Cochrane database of systematic reviews (Online) (3): CD004417. DOI:10.1002/14651858.CD004417.pub3. PMID 17636757. Research Blogging.
- ↑ Moore M, Little P, Rumsby K, Kelly J, Watson L, Warner G et al. (2009). "Effect of antibiotic prescribing strategies and an information leaflet on longer-term reconsultation for acute lower respiratory tract infection.". Br J Gen Pract 59 (567): 728-34. DOI:10.3399/bjgp09X472601. PMID 19843421. PMC PMC2751917. Research Blogging.
- ↑ Little P, Turner S, Rumsby K, et al (March 2009). "Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study". Health Technol Assess 13 (19): iii–iv, ix–xi, 1–73. DOI:10.3310/hta13190. PMID 19364448. Research Blogging.