A new lexicon for polypharmacy: Implications for research, practice, and education

Area of Science:

• Health Services Research
• Pharmacology
• Patient Safety

Background:

• Polypharmacy is a significant healthcare challenge with over 24 inconsistent definitions, causing confusion.
• Existing definitions focus on medication quantity, which may not predict adverse events.
• Current polypharmacy definitions can encompass both appropriate and inappropriate medication use.

Purpose of the Study:

• To propose a lexicon change for polypharmacy to reduce confusion.
• To introduce a new term, "extraordinary prescribing," for harmful medication regimens.
• To stimulate dialogue on improving prescribing practices and patient safety.

Main Methods:

• Literature review of existing polypharmacy definitions.
• Conceptual analysis to propose new definitions.
• Qualitative discussion to introduce "extraordinary prescribing."

Main Results:

• Identified at least 24 distinct definitions of polypharmacy.
• Proposed redefining polypharmacy as patients using more than one pharmacy.
• Introduced "extraordinary prescribing" for excessive or non-beneficial medication use, irrespective of quantity.

Conclusions:

• The proposed redefinition of polypharmacy and introduction of "extraordinary prescribing" aim to clarify research and improve patient safety.
• Focusing solely on medication count is insufficient for identifying harmful prescribing.
• Further research is needed to understand and address inefficient prescribing practices.