Polypharmacy

Medication is by far the most common form of medical intervention for many acute and chronic conditions. Drug therapy can be highly effective in preventing disease or slowing disease progression. However, there is often a mismatch between prescribing guidelines for specific medical conditions and the range of clinical complexity found in individual adults.

The interest in polypharmacy management is now international. The third WHO global patient safety challenge, Medication without Harm, has appropriate management of polypharmacy as a key flagship area to address.

We are delighted to present the Polypharmacy Guidance 2018, which aims to provide guidance on preventing inappropriate polypharmacy at every stage of the patient journey. This builds on and refines the previous guidance from 2012 and 2015.

It provides:

  • A clear structure for a medicines review that is centred around the individual adult;
  • A focus on knowledge and understanding;
  • Worked examples presented as case studies;
  • Medicines safety;
  • Drug efficacy and applicability table.

The 2018 version of the guidance can be found here.

* ERRATA: Please note a small error has been found in the printed version of guidance within the  NNT table, relating to alendronate prescribing. An updated version of the NNT for alendronate can be found here. This mistake has been corrected in the guidance which is linked above.

* Please note an error has been found in the printed version of guidance within Table 1.2.1, “High Risk Medicines” on Page 10 relating to BNF Section 2.1 – Diclofenac should NOT be included in the example list. This mistake has been corrected in the guidance which is linked above. This will also be corrected in the polypharmacy mobile app.

This guidance aims to support those carrying out comprehensive medication  reviews with a conversation with patients and where appropriate carers and welfare proxies (e.g. those with power of attorney regarding health related issues), regardless of communication channel. These conversations allows the patient to be in control of their care and supports joint decision making. A patient information leaflet for medication reviews is available to download here.