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QJM Advance Access first published online on October 9, 2006
This version published online on October 17, 2006
QJM, doi:10.1093/qjmed/hcl109
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: Journals.permissions@oxfordjournals.org

Commentary

Escalating polypharmacy

D.A. Gorard 1 *

1 From Wycombe Hospital, High Wycombe, UK

* To whom correspondence should be addressed.
D.A. Gorard, E-mail: david.gorard{at}buckshosp.nhs.uk


  Abstract

New drug treatments, new indications for older drug treatments, lower thresholds for treating risk factors in preventative medicine, and an ageing population acquiring multiple pathologies all contribute to the development of polypharmacy. Longitudinal studies document the rise in prescribed medications, particularly in the elderly. The potential dangers of adverse drug reactions and interactions, poor adherence and confusion associated with ever-increasing polypharmacy are likely to worsen. Strategies to reduce prescribing will obviously decrease the dangers of polypharmacy. These include more considered prescribing when contemplating additions to patients' already lengthy prescription lists, and external reviews of medicine lists by a doctor or pharmacist. Despite such strategies, polypharmacy seems inevitable and considerations must be given to simplifying patients' multiple drug administrations using single-daily-dose regimens, fixed-dose combination pills, calendar-blister packaging and pill organizers.


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