Polypharmacy refers to the use of many medicines at the same time. In the UK, around onethird of people over 75 in the community take four or more medicines. Polypharmacy increases drug costs and waste.

From a patient perspective, polypharmacy can lead to adverse drug reactions and poor therapeutic outcomes. Increasing the number of medicines taken and doses can reduce adherence. A complex medicine regimen can make people feel socially restricted.

Older people with poor medicine adherence may require support from a carer or need to move into a care home. The risk of adverse drug reactions increases exponentially with the number of medicines taken and regular monitoring is important to keep the number of medicines to a minimum. Before any medicines are added, the prescriber must consider whether the symptom is caused by the underlying condition or the medicine regimen.