Drug Prescribing: Polypharmacy and Deprescribing

Area of Science:

• Geriatrics and Gerontology
• Clinical Pharmacy
• Pharmacology

Background:

• Polypharmacy, concurrent use of five or more drugs, affects patients across all age groups.
• While polypharmacy can be appropriate, inappropriate polypharmacy significantly elevates risks.
• Risks associated with inappropriate polypharmacy include hospitalization, adverse drug events, and increased mortality.

Purpose of the Study:

• To review strategies for identifying and managing inappropriate polypharmacy.
• To highlight the importance of tools and collaborative approaches in optimizing medication use.
• To emphasize the benefits of deprescribing for improved patient health outcomes.

Main Methods:

• Discussion of implicit tools (e.g., Medication Appropriateness Index) and explicit tools (e.g., AGS Beers Criteria) for assessing drug appropriateness.
• Emphasis on the role of pharmacist collaboration in reducing drug-related problems.
• Advocacy for a patient-centered, team-based approach to deprescribing.

Main Results:

• Inappropriate polypharmacy is linked to increased hospitalizations, adverse drug events, and mortality.
• Pharmacist collaboration has demonstrated reductions in drug-related problems and hospital visits.
• A structured, patient-centered approach to deprescribing is effective.

Conclusions:

• Identifying and addressing inappropriate polypharmacy is crucial for patient safety and well-being.
• Utilizing available assessment tools and interprofessional collaboration enhances medication management.
• Systematic deprescribing, involving patient agreement and evidence-based strategies, leads to better health.