[Polypharmacy and deprescribing in cardiology]

Area of Science:

• Pharmacology
• Geriatrics
• Internal Medicine

Background:

• Polypharmacy, the use of multiple drugs, is increasing due to longer life expectancy and multimorbidity.
• Factors contributing to polypharmacy include industry pressures, managing adverse drug events, subspecialty fragmentation, and guideline implementation.
• Adverse events associated with polypharmacy are a growing concern in patient care.

Purpose of the Study:

• To highlight the importance of avoiding inappropriate prescribing and revising therapeutic plans.
• To emphasize the need for deprescription to reduce drug burden and associated risks.
• To discuss the role of guidelines and tools in identifying and mitigating polypharmacy risks.

Main Methods:

• Reviewing scientific literature on polypharmacy and its adverse effects.
• Utilizing recommendations from initiatives like the international Choosing Wisely project.
• Employing programs that evaluate drug interactions and risks, particularly in the elderly.
• Examining evidence on the safety of deprescribing cardiovascular treatments.

Main Results:

• Polypharmacy is linked to increased adverse events and is driven by multiple factors.
• Tools and guidelines exist to identify potentially inappropriate medication use.
• Reducing or withdrawing certain cardiovascular drugs under supervision is safe and beneficial.

Conclusions:

• Regular revision of therapeutic plans and deprescription are essential for good medical practice.
• Addressing polypharmacy requires a multifaceted approach considering patient profiles and evidence-based recommendations.
• Deprescribing, especially for cardiovascular treatments, can lead to documented patient benefits.