What is Polypharmacy?

Polypharmacy, defined as the simultaneous use of medications to treat the same ailment, is plaguing our older adult population. It is estimated that 30-40% of seniors take 5 or more medications. When it comes to complex illnesses, such as cancer, heart disease and hypertension, it is common that multiple medications are used to manage symptoms.

A contributing factor to polypharmacy is that patients are often seeing multiple physicians, such as visiting their primary physician, specialists and occasionally a physician in urgent care or the emergency department.

 

Risks of polypharmacy

One of the main risks of polypharmacy is drug to drug interactions. If an adverse effect occurs, it can be very difficult to figure out which of the many drugs is the cause, and the correct treatment for the adverse effect. Harmful effects of taking multiple medicines can include:

  • Falls and fractures (due to dizziness/grogginess)
  • Memory problems
  • Hospitalization
  • Higher risk of death


Multiple medications increase the risks of inappropriate medication use, non-adherence, and adverse effects. Another unwanted effect could be that physicians may hesitate to prescribe a new essential medication to a patient already on five or more. Thus, ironically, polypharmacy can lead to under-treatment.

What action should I take?

Regular medication reviews should happen to ensure that a patient is only taking what is needed. Here are some helpful questions to ask a doctor or pharmacist:

  • Do I still need to take all of my medicines?
  • Are all my medicines still helping me to stay well?
  • Could any of my medicines be causing ________?
  • Could any of my medicines be affecting the others?
  • Is there anything I can stop taking safely

 

Deprescribing is what occurs when a medical professional reviews the medication list of a patient and begins discontinuing medications. It involves patients, their family and/or caregiver, doctors and pharmacists who together:

  1. Review all medicines a person is taking and why
  2. Identify how likely each medicine will cause problems
  3. Identify if each medicine is still right for the person or could be stopped
  4. If medicines can be stopped, prioritize which should be stopped first
  5. Agree on a management plan
  6. Stop medicines carefully, one by one
  7. Meet frequently to see if the plan works or the patient is experiencing problems.

 

Polypharmacy puts seniors living alone at risk for various problems, but knowing your medications and consulting with your health care team is paramount to keeping yourself or your loved ones safe.

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