What is a Polypharmacy?

Polypharmacy or “many drugs” is a situation which occurs when a patient takes numerous drugs, both prescription and over the counter. This situation is most common in the elderly, as they often have complex medical conditions which necessitate the use of numerous medications for proper management, but it can happen in people of any age. Doctors make a distinction between studied and unstudied polypharmacy, or thoughtless versus thoughtful, to stress that sometimes polypharmacy occurs by necessity, and at other times, it can actually endanger the patient.

The more drugs someone takes, the more he or she is at risk of adverse reactions. If a patient gets all prescriptions from the same doctor and fills them at the same pharmacy, any concerns about drug interactions are usually addressed quickly. However, when a patient gets prescriptions from several doctors who may not communicate, or fills prescriptions in multiple locations, or buys over the counter drugs such as aspirin, herbal medicine, and so forth and does not disclose this, adverse drug reactions can occur, and they may not be identified by a doctor.

Polypharmacy can also set up a situation known as pill burden, in which a patient has so many drugs that he or she cannot manage them all properly. Pill burden can increase the risk of noncompliance, and the patient may also accidentally overdose, fail to take certain medications, or take drugs at the wrong time as the pill burden grows excessive.

In some patients, the polypharmacy may be considered necessary. AIDS patients, for example, usually need to take a lot of medications, and each medication's usage is evidence-based and entirely appropriate. On the other hand, a patient taking an eclectic assortment of drugs which may include drugs taken to cope with side effects from other drugs may be considered to be a victim of unstudied polypharmacy, in which a doctor fails to completely evaluate the situation, or does not have the information necessary to do so.

Patients can reduce the risk of polypharmacy by seeing one primary care provider, and asking that specialists forward their medical charts and prescription information to the primary care provider. It is also important to keep a list of all medications being used, including prescriptions, over the counter drugs, herbal regimens, and so forth. Patients may feel shy about revealing all of their medications, but this is vitally necessary, as failure to disclose medication usage can result in severe complications or even death.