Research by the Royal College of Surgeons in Ireland found a 250% increase in the prevalence of polypharmacy
- the use of five or more drugs by a single patient.
We need to pay special attention to polypharmacy
, or multiple drugs taken at once, when prescribing psychotropic drugs in this population because so many older adults are already on multiple medications," said Donovan Maust, MD, MS, an author of the study and an assistant professor in the University of Michigan Department of Psychiatry.
Combinatorial approach improves medication adherence and reduces polypharmacy
in patients treated with antidepressants and antipsychotics
Guidelines for treating patients with psychotic disorder (1) have consistently recommended antipsychotic monotherapy (APMT) as the treatment of choice; however polypharmacy
(APPP) is widespread in daily clinical routine (1).
There are five attributes of complexity of care: polypharmacy
, use of advanced technologies, novel care models, fragmentation of the health care system, and the relational nature of caregiving.
Deprescribing is a relatively new term that can be defined as "the process of tapering, stopping, discontinuing, or withdrawing drugs, with the goal of managing polypharmacy
and improving outcomes" (Thompson & Farrell, 2013).
The problem of polypharmacy
is growing hotter for caregivers at all levels.
and the Efficacy and Safety of Rivaroxaban versus Warfarin in the Prevention of Stroke: Results from the ROCKET AF Trial, Oral Presentation: AOS.
Comorbidity makes achievement of a 50% improvement in symptoms more challenging, and is associated with more complex medication strategies, including more changes in medication and more use of polypharmacy
We determined that the overuse of medication had arisen through five different avenues: (1) polypharmacy
in general (which is common in recently hospitalized patients with comorbidities and disabilities), especially the "unholy trinity" drug combination (opioids, benzodiazepines, and muscle relaxants with sedating properties); (2) sedatives for sleep in a population at risk for sleep apnea; (3) overuse of acetaminophen (risk of liver toxicity); (4) opioid use for inappropriate conditions; and (5) inadequate awareness of the need to decrease dosages as people age, or have changes in ability to metabolize medications, or have changes in body mass.
Discuss the risks associated with polypharmacy
and strategies that may help to reduce these.
New to the text are 16 chapters that include polypharmacy
, delirium, culture and spirituality, elder abuse, pain management, sleep disorders, pressure ulcers, among others.