I read a recent article in AMA Journal of Ethics, "When Should Iatrogenic Polypharmacy
Be Considered a Disease?
Womack, Ph.D., from the VA Connecticut Healthcare System in West New Haven, and colleagues investigated whether the association between polypharmacy
, hazardous alcohol and illicit substance use, and serious falls differed by HIV status among participants in the Veterans Aging Cohort Study.
The study also noted that the simultaneous use of multiple medications, known as polypharmacy
, plays a significant role in serious falls among patients who are HIV positive and those who are not.
is often defined as the simultaneous prescription of multiple medications (usually [greater than or equal to]5) to a single patient for a single condition or multiple conditions.
, Prescription pattern, Psychotropic drugs, Schizophrenia.
According to the researchers, patients more susceptible to unintended harm from these medicines are individuals older than 65 years, those taking more than five different medications at the same time (polypharmacy
) and those with many coexisting medical diseases.
The use of first-line anti-dementia drugs, namely acetylcholinesterase inhibitors, was associated with a decreased risk of psychotropic polypharmacy
, whereas memantine use was associated with an increased risk.
Also, there are more medical conditions like diabetes, hypertension, and arthritis, that require medications, so we often have the additional issue of polypharmacy
and the side-effects of medications to consider." Dr Mahmoud noted that these changes are not linear; some older patients remain highly active while some are partially or totally dependent on others.
Frew outlined the harm that can occur when patients are prescribed more than five medications (polypharmacy
People age 85 and older and diabetics were more likely to demonstrate poor adherence and discontinuation, while people with high blood pressure, angina (chest pain), heart failure, and polypharmacy
(concurrent use of five or more drugs) were more likely to take their meds as directed.
Once I am satisfied the software works, I will apply it to a research project run by Dr Sarah Slight (School of Pharmacy, Newcastle University), asking whether patients treated with many medications ("polypharmacy
") have poorer outcomes (eg more falls, hospital admissions).
In 2016, Cook County Health (CCH) led a research study that showed many aging HIV positive patients lived alone, and the interplay of co-morbidities, polypharmacy
, memory issues and falls placed them at an increased risk for non-independent living at an earlier age than the general population.