Medication management is a challenging process, and it becomes more difficult the more medications are involved. Polypharmacy relates to a patient taking more than one medication at the same time, which creates additional risks that must be controlled.
What is polypharmacy?
There is no one, universally agreed definition of polypharmacy, but the term is generally used to refer to situations when a person is taking more than one medication simultaneously. Sometimes, just two medications at the same time may be enough to describe polypharmacy. In other cases, it may take more, such as a combination of at least five, for polypharmacy to be considered an appropriate label. Another definition of polypharmacy is when someone is prescribed more medications than are clinically necessary.
Polypharmacy is often associated with the elderly, as they often have many different health issues at the same time (known as multimorbidity), but it can impact all age groups, including children and young people. It is also more common in people with disabilities and/or mental health conditions. As lifespans, medical understanding and available treatments all expand, polypharmacy and its associated risks are becoming increasingly frequent.
What are the risks of polypharmacy?
Sometimes, it is necessary to give someone multiple medications to protect their life and health. Nevertheless, the more medications that are prescribed, the greater the risk of complications, side effects and adverse reactions. This can, in turn, lead to increased hospital admissions. Not only is this harmful to patients, but it may also increase costs. Patients who feel they are taking too many medications or are experiencing side effects also find it more difficult to adhere to a prescription, which can create further problems.
How can the risks of polypharmacy be managed?
Not all incidents of polypharmacy are necessary. Sometimes, it results from overprescribing. This is when someone is prescribed a medication that is not required, or where its potential harms outweigh any benefits. Not all medications available for a particular condition will suit every individual patient, and sometimes more appropriate treatments will be available.
When someone is taking multiple medications, it is important to regularly review all their prescriptions, especially if their situation changes (whether because a medical issue has been resolved, or a new health problem has developed and needs treating). The risk of polypharmacy should be identified early and continue to be an ongoing consideration. Everyone involved in the patient’s care should be involved, including the patient themselves.
This awareness and ongoing review allow professionals to identify which medications are actually essential or providing real benefits, as well as cases where a different treatment may be preferable, where doses can be reduced, or even when a medication can be deprescribed altogether. To do this, it is important to talk to the patient about their experiences with their prescription, both medically and practically. Deprescribing, in particular, is a complex process with risks of its own and requires full communication with and cooperation from the patient and other relevant healthcare professionals.
If a patient is taking multiple medications, it is important to fully consider the potential risks and, if necessary, take steps to mitigate them. This means identifying which medications are truly essential, which are genuinely beneficial, and which may be reduced or even deprescribed.
What services does Clinical Rx provide?
In general, clinical pharmacists exist to help with the management of medication. They ensure patients receive the correct prescription, that it works as intended, that potential side effects are monitored, that their dosage is adjusted as needed, and that reviews are carried out as necessary. This is of particular use for those with chronic conditions who require long term management, and who are particularly reliant on the ongoing support of their GP practice.
Utilisation of clinical pharmacists allows the practice as a whole to work more efficiently, ensuring doctors can focus on more complex diagnoses and treatments, and it improves the patient experience by providing them with quicker and more tailored care. Increased efficiency in time, organisation and costs ensures ARRS funding is put to good use, to the benefit of a practice or entire PCN.
There are several benefits to utilising the services of Clinical Rx, in particular, which works as a remote clinical pharmacist provider supporting a range of PCNs and practices as needed on a flexible basis. As well as streamlining prescription management and reviews, relieving pressure on GPs, and improving patient care, it can clear the backlog and help meet QOF targets. Meeting QOF targets, in particular, allows you to be rewarded for good performance, increasing your practice income. This makes ARRS funding a profitable investment as well as one that is effective in terms of patient outcomes.
It can be a difficult decision to decide how best to use ARRS funding, but Clinical Rx can provide specific benefits for patients and doctors both in terms of efficiency and cost effectiveness. This leads to better outcomes for everyone in the PCN or practice, and for the PCN or practice itself.
For improved outcomes, we believe that communication is vital between the different professions. At Clinical Rx®, we welcome feedback and reviews, so we can continue to offer the best possible service. By working together, the team can better address the complex needs of patients, improve outcomes, and enhance the overall patient experience. Ultimately, the goal is to provide high-quality care in a collaborative and patient-centred approach.Â
Our Pharmacists are not limited to medication management only. We understand that every GP Practice has different needs at times. Whether it be assistance with protocols, quality improvement work or additional work for CQC inspections – we can help, contact us for more information.Â
References: 1. Duncan, P. et al. (2020) ‘Barriers and enablers to collaborative working between GPS and Pharmacists: A qualitative interview study’, British Journal of General Practice, 70(692). doi:10.3399/bjgp20x708197.
