The existence of multiple chronic situations elevates the complication of therapeutic administration for both patients and health professionals, and affects negatively on health results (Roughead et al., 2011).

The usage of multiple medications, generally referred to as polypharmacy is popular in the older people with multimorbidity, as one or more medications may be utilized to treat each situation (Caughey et al., 2010).

Multimorbidity is linked with reduced self-rated health, quality of life, functional capability and mobility, as well as raises in hospitalisations, usage of health care resources, mortality, physiological distress, and costs (Roughead et al., 2011).

The expression polypharmacy, which first manifested in the medicinal literature since more than one and half centuries, was primarily coined to refer to confirmed problems linked to multiple medication consumption and excessive medication usage (Mortazavi et al., 2016).

Since then, it has been utilized in various reports and papers, and with various definitions and meanings containing but not restricted to ‘medication use without indication’ and ‘unnecessary drug use’ (Riker and Setter, 2012).

However, Polypharmacy is linked with adverse results containing extended length of stay in hospital, readmission to medical center soon after discharge, adverse drug reactions, mortality, and falls (Caughey et al., 2010). The danger of harm and adverse effects elevates with increasing numbers of drugs (Maher et al., 2014).

Polypharmacy has been differently defined. It has been realized as the concurrent usage of multiple medications, and some researchers have differentiated between minor (two medications) and prime (more than four medications) polypharmacy (Fulton and Allen, 2005).

Others have realized it as the usage of more medications than are clinically pointed out or too many unsuitable medications, as two or more drugs to treat the similar situation and as the usage of two or more medications of the similar chemical class (Viktil et al., 2007).

Older commune are more vulnerable to mortality and morbidity secondary to medication-linked damages because of age-linked pathologies and alterations; comorbidity of chronic situations, like cardiovascular ailments and psychological troubles; and various pharmacodynamics and pharmacokinetics. As a result, older adults are more liable to adverse drug reactions (ADR) (Prybys et al., 2002).

Drug-related damage among the elderly is actually one of the most demanding public health problems globally (Patterson et al., 2012). Lower adherence and compliance because of multiple and complex medication regimens are some of the troubles among the old that can intervene with the therapy procedure, exacerbate illness and eventually elevate the demand for medication.

Polypharmacy has become and always will be popular among the old population because of the demand to treat the diverse illness states that improve as a patient ages. Unluckily with this raise in the usage of multiple drugs comes with an elevated danger for negative health outcomes like medication non-adherence, drug-interactions, higher healthcare costs, reduced functional state and geriatric syndromes.

References:

Caughey, GE., Roughead, EE., Pratt, N. et al. (2010). Increased risk of hip fracture in the elderly associated with prochlorperazine: is a prescribing cascade contributing? Pharmacoepidemiol Drug Saf., 19(9):977–982.

Fulton, M. M. and Allen, E. R. (2005). Polypharmacy in the elderly: a literature review. J Am Acad Nurse Pract., 17:123–32.

Maher, RL., Hanlon, J., & Hajjar, ER. (2014). Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf., 13(1):57–65.

Mortazavi, S. S., Shati, M., Keshtkar, A. et al. (2016). Defining polypharmacy in the elderly: a systematic review protocol. BMJ open, 6(3): e010989.

Patterson, S. M., Hughes, C., Kerse, N. et al. (2012). Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev., 16(5):CD008165.

Prybys, K., Melville, K., Hanna, J. et al. (2002). Polypharmacy in the elderly: clinical challenges in emergency practice: part 1 overview, etiology, and drug interactions. Emerg Med Rep, 23:145–53.

Riker, G. I., and Setter, S. M. (2012). Polypharmacy in older adults at home: what it is and what to do about it—implications for home healthcare and hospice. Home Healthc Nurse, 30:474–85.

Roughead, E. E., Vitry, A. I. et al. (2011). Multimorbidity, care complexity and prescribing for the elderly. Aging Health., 7(5):695–705.

Viktil, K. K., Blix, H. S. et al. (2007). Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug-related problems. British journal of clinical pharmacology, 63(2): 187–195.