POLYPHARMACY
Polypharmacy is the concurrent use of multiple medications to treat one condition or multiple concurrent conditions. It includes the use of all prescription medicines, over-the-counter medicines, and complementary medicines.
Polypharmacy use is significantly higher in people with disability. This is partly because people with a disability are more likely to have multiple health conditions, such as epilepsy, diabetes, stroke, heart problems, high blood pressure, and arthritis compared to the general population.
When is polypharmacy more likely?
High rates of polypharmacy are associated with participants who:
- live in a residential setting
- receive prescriptions from multiple prescribers
- have moderate to severe intellectual or developmental disability
- have a poorer overall health status
- have co-occurring psychiatric, neurological or developmental disorders
- have multiple neurological or psychiatric diagnoses
What are the risks associated with polypharmacy?
Large-scale studies have shown that polypharmacy increases the risk of drug-related adverse effects. It is a leading reason for medication-related hospitalisations, can decrease the benefit of individual medications, and is associated with poor health outcomes.
The use of multiple antipsychotics can increase the risk of:
- movement disorders
- hormone disorders
- sexual dysfunction
- obesity
- diabetes
- stroke and heart attack
- memory issues
- falls
Importance of polypharmacy review
Despite the risks associated with polypharmacy, it may be the most appropriate treatment, particularly for people with multiple conditions.
To ensure participants are receiving the correct medications, a review of all medications by a medical practitioner and pharmacist allows each drug to be assessed in terms of need, current and recommended dosages, benefit versus risk of potential adverse effects or other side effects, and possible interactions between medications.
Regular medication reviews can prevent or minimise polypharmacy-related adverse effects and related hospitalisations, by helping participants, support workers, carers and caregivers to better understand how to use the medications correctly, and how to manage potential adverse effects.
People with disability are among those most at risk of polypharmacy due to comorbid health conditions and the common use of several medicines of the same class (e.g. antipsychotics). A medical practitioner should conduct a medication review every 3–6 months, or when requested by the participant, their carer or other health or disability professionals.