Polypharmacy

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Reproduced from Scottish Government Polypharmacy Model of Care Group


Terminology  

Polypharmacy = many medications (two or more)

Appropriate polypharmacy - all drug prescribed for the purpose of achieving specific therapeutic objectives that have been agreed with the patient. eg polypharmacy is beneficial in secondary prevention of myocardial infarct (antiplatelets, statin, ACE inhibitor, beta blocker)

Inappropriate polypharmacy - one or more drugs are prescribed that are no longer needed


According to the Scottish Government Polypharmacy Model of Care Group, 5 stages which trigger:

1. Prescribing (and risk assessment)

2. Medication review

3. Dispensing and administration

4. Communication and patient engagement

5. Medication reconciliation (at care transitions)


High-Risk Medication for Adverse Drug Reactions (ADRs)



7-Steps Medication Review

1. (Aim) What matters to patients?

2. (Need) Identify essential drug therapy

3. (Need) Does the patient take unnecessary drug therapy?

4. (Effectiveness) Are therapeutic objectives being achieved?

5. (Safety) Is the patient at risk of ADRs or suffers actual ADRs?

6. (Efficiency) Is the drug therapy cost-effective?

7. (Patient-centred) Is the patient willing and able to take drug therapy as intended?




Sick Day Rules Card



References

Scottish Government Polypharmacy Model of Care Group. Polypharmacy Guidance, Realistic Prescribing 3rd Edition, 2018. Scottish Government. Available on https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/04/Polypharmacy-Guidance-2018.pdf.  Accessed: 15/3/2022.


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