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Polypharmacy as Formal Training and a Model of Practice
Michael J Schuh1, Sheena K Crosby1
11 Clinical Pharmacist, Mayo Clinic, Jacksonville, Florida.
The Senior Care Pharmacist
|April 30, 2024
Summary
Polypharmacy definitions need updating to include supplements and cannabis. Pharmacists can manage complex medication regimens, including pharmacogenomics (PGx), to prevent adverse drug reactions.
Area of Science:
- Pharmacology
- Pharmacy Practice
- Integrative Medicine
Background:
- Traditional polypharmacy definitions overlook herbal supplements, cannabis, and pharmacogenomics (PGx).
- Most pharmacists encounter polypharmacy across various patient care settings.
- Geriatric populations traditionally experience higher polypharmacy rates, but younger individuals are increasingly affected due to supplement and cannabis use.
Purpose of the Study:
- To highlight the limitations of current polypharmacy definitions.
- To emphasize the role of pharmacists in managing complex medication regimens involving supplements and cannabis.
- To advocate for enhanced polypharmacy training in pharmacy curricula.
Main Methods:
- Reviewing traditional polypharmacy definitions and their limitations.
- Analyzing the impact of herbal supplements and cannabis on drug interactions.
- Exploring the integration of pharmacogenomics (PGx) into polypharmacy management.
- Assessing current pharmacy curricula for polypharmacy training adequacy.
Main Results:
- Existing polypharmacy definitions do not adequately address the widespread use of supplements and cannabis.
- These products can share metabolic pathways with prescription drugs, increasing the risk of drug interactions and adverse drug reactions (ADRs).
- Pharmacogenomics (PGx) offers a valuable tool for personalized medication management in polypharmacy.
- Pharmacy education on polypharmacy is often fragmented and lacks comprehensive coverage of non-prescription products.
Conclusions:
- Polypharmacy is a growing concern across all age groups, driven by the proliferation of supplements and cannabis.
- Pharmacists, equipped with knowledge of pharmacology, pharmacokinetics, and PGx, are crucial in addressing medication-related problems (MRPs) arising from polypharmacy.
- Formalizing and prioritizing polypharmacy education within pharmacy curricula is essential to prepare future pharmacists for this complex practice environment.
- A "polypharmacist" model can improve patient safety and outcomes by proactively managing polypharmacy.
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