The definition of polypharmacy most cited in literature is the taking of five or more medications simultaneously. But a more appropriate definition might be the taking of any medication that is not clinically warranted. More than just a term that describes the taking of many medications, polypharmacy is a risk factor for morbidity and mortality. Adverse medication outcomes have been estimated as the fourth or fifth leading cause of mortality in hospitals (1). In 2000, medication related problems cost $85 billion dollars and 106,000 lives (2); by comparison, in 2002 diabetes cost $91.8 billion dollars, and 224,092 lives (3).
If polypharmacy were a disease, there would be numerous initiatives and organizations to fight its threat to public health. The problem of polypharmacy touches everyone's life either with their own medical experience, or through family members or friends who struggle to deal with managing medication regimens in every way from costs, follow-up appointments, lab tests, to ability to take several medications at the right time every day. The enormity of this problem is coming to public attention more and more as people face caring for chronically ill loved ones, something that demands understanding Medicare D, insurance access issues and the myriad of information needed to correctly use complex drug therapy.
The days of one doctor (who can spend ample time to address all aspects of care), one pharmacy (with a pharmacist who can spend the time it takes to go over the use of every medication in detail), and the use of just a handful of medications are all but non existent today.
Polypharmacy is not a diagnosis given to a person by a doctor, but it is a phenomenon that carries as much risk as many other diagnosable disease states. It is important to understand the risk that polypharmacy poses, its causes, and what each person or care giver can do to minimize medication related problems.
It is not enough to “blindly” take medications prescribed by several separate prescribers, or take recommended over-the-counter products based on advertising and marketing, and not question the total drug picture as it applies to your unique mix of health conditions. Increasing awareness amongst everyone, care givers, family and friends about the causes of and how to avoid medication related problems can help the whole community, both within and outside the healthcare community improve medication use outcomes.