CPD activity

Before you start reading this article, think about:

• What do I want to learn?
• What will I gain from this learning?
• What will my employer gain?
• What difference will it make to people who use my services?

Polypharmacy literally means ‘many medicines’. It is often mentioned with negative connotations. However, it is important to note that polypharmacy is not necessarily a bad thing.

For example, secondary prevention of myocardial infarction often requires the use of four different classes of drugs and, in this instance, is both rational and required. Problematic polypharmacy means medicines are prescribed that are not or no longer needed. This can happen for several reasons, such as:

• There is no evidence-based indication; the indication has expired, or the dose is unnecessarily high
• Medicines are being prescribed to treat the side effects of other medicines where alternative solutions are available
• The medicine fails to achieve the therapeutic objectives it is intended to achieve
• Medicines cause unacceptable adverse drug reactions (ADRs)
• The demands of the medicinetaking are unacceptable to the patient or the patient is unable to maintain adherence.

In this series of modules, the term polypharmacy will mean problematic polypharmacy.