April 2018
The practice of taking multiple drugs to treat one or more medical conditions or polypharmacy is prevalent due to the growth of the pharmaceutical industry making more drugs available. In many situations polypharmacy is necessary to treat chronic disease, but it can pose a challenge to both patients and providers.
When patients take multiple medications:
- More side effects can occur
- Side effects may be mistaken for disease symptoms
- A prescribing cascade can occur; medications are prescribed to treat side effects caused by other medications
- Complicated regimens may create dosing and scheduling mistakes
- Adherence issues can arise
Polypharmacy is more likely when:
- Multiple prescribers are involved
- Patients utilize multiple pharmacies
- Patients self-medicate with “over the counter” medications or herbal preparations
Seniors are at highest risk for polypharmacy because they tend to have more co-morbidities and less efficient elimination caused by aging or impaired renal/hepatic function. Polypharmacy can be effectively managed by maintaining an awareness.
To maintain awareness of polypharmacy, providers should:
- Be vigilant in monitoring for the onset of new symptoms (particularly after starting new medications)- this could be caused by adverse drug reactions
- Keep drug regimens as simple as possible
- Ask patients if they take over-the-counter and herbal preparations
- Review medication and dosing schedules at each appointment
Visit the L.A. Care list of covered drugs page for information about the Formulary and monthly Formulary updates. You will also find information about Formulary limits or quotas, generic and brand medications, restrictions on medication coverage, the medication request process, drug preferences and how to use the Formulary procedures.