Polypharmacy

Colley, Colleen A.; Lucas, Linda M.

doi:10.1007/bf02600099

Cited by 153 publications

(43 citation statements)

References 40 publications

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“…A range of definitions have been applied to the term polypharmacy , including the use of at least one unnecessary medication and different thresholds for the number of medications in a patient’s regimen [7, 8, 31]. There is a clear dose–response association with harms of polypharmacy, so that those who are on 5–6 medications are at lower risk than those on 7–8 or >9 medications [32–34].…”

Section: What Is Polypharmacy?mentioning

confidence: 99%

The Next Therapeutic Challenge in HIV: Polypharmacy

et al. 2013

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With the adoption of combination antiretroviral therapy (ART), most HIV-infected individuals in care are on five or more medications and at risk of harm from polypharmacy, a risk that likely increases with number of medications, age, and physiologic frailty. Established harms of polypharmacy include decreased medication adherence and increased serious adverse drug events, including organ system injury, hospitalization, geriatric syndromes (falls, fractures, and cognitive decline) and mortality. The literature on polypharmacy among those with HIV infection is limited, and the literature on polypharmacy among non-HIV patients requires adaptation to the special issues facing those on chronic ART. First, those aging with HIV infection often initiate ART in their 3rd or 4th decade of life and are expected to remain on ART for the rest of their lives. Second, those with HIV may be at higher risk for age-associated comorbid disease, further increasing their risk of polypharmacy. Third, those with HIV may have an enhanced susceptibility to harm from polypharmacy due to decreased organ system reserve, chronic inflammation, and ongoing immune dysfunction. Finally, because ART is life-extending, nonadherence to ART is particularly concerning. After reviewing the relevant literature, we propose an adapted framework with which to address polypharmacy among those on lifelong ART and suggest areas for future work.

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Section: What Is Polypharmacy?mentioning

confidence: 99%

The Next Therapeutic Challenge in HIV: Polypharmacy

et al. 2013

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“…Patients must be able to track what they are taking, why they are taking it, and how it should be taken to ensure safe and effective use. This has become increasingly difficult given that patients' drugs are frequently changed by prescribers and/or switched for generic alternatives by their insurer (Catz, Kelly, Bogart, Benotsch, & McAuliffe, 2000; Colley & Lucas, 1993). In addition, patients taking complex regimens may have trouble differentiating instructions for each drug (Hoffman & Proulx, 2003).…”

Section: Deconstructing Medication Self-management: Defining the Modelmentioning

confidence: 99%

Rethinking Adherence: A Health Literacy–Informed Model of Medication Self-Management

Bailey

Oramasionwu

Wolf

2013

Journal of Health Communication

119

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Medication adherence has received a great deal of attention over the past several decades; however, its definition and measurement remain elusive. The authors propose a new definition of medication self-management that is guided by evidence from the field of health literacy. Specifically, a new conceptual model is introduced that deconstructs the tasks associated with taking prescription drugs; including the knowledge, skills and behaviors necessary for patients to correctly take medications and sustain use over time in ambulatory care. This model is then used to review and criticize current adherence measures as well as to offer guidance to future interventions promoting medication self-management, especially among patients with low literacy skills.

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“…The complications of polypharmacy are multiple such as increased problems with side effects of medications, adverse drug reactions, drug-drug interactions, noncompliance with the medical regimen, and direct cost of drugs as well as indirect costs resulting from hospitalization for iatrogenic illnesses. [10]…”

Section: Discussionmentioning

confidence: 99%

Prescribing practices of topical corticosteroids in the outpatient dermatology department of a rural tertiary care teaching hospital

et al. 2013

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Background:Inappropriate or excessive use of topical corticosteroids can lead to cutaneous and systemic adverse effects which occur more commonly with the use of very potent steroids. Monitoring and analysis of the prescription practices of topical steroids can help to achieve rational prescription of these drugs.Aim:The present study was carried out to study and analyze the pattern of prescribing topical corticosteroids among outpatients attending the dermatology clinic in a rural tertiary care and teaching hospital, Ambajogai, Maharashtra.Materials and Methods:A cross-sectional descriptive study was conducted for a duration of two months from August 2011 to September 2011, and 500 prescriptions were randomly collected from the dermatology pharmacy and analyzed.Results:About 66% of the prescriptions contained four to five drugs per prescription. Topical steroids were given in 28.4% of all the prescriptions. In almost all the prescriptions, strength, quantity of the steroid to be used, frequency, site, and duration of application was not mentioned. The chief complaints and diagnoses were not mentioned in about 85% of the prescriptions for topical corticosteroids. About 94.36% of the prescriptions contained very potent steroids.Conclusion:Inadequate prescribing information is a clear characteristic of the dermatological prescriptions containing topical corticosteroids. Doctors should be educated about the importance of giving patients sufficient information regarding the use of steroids. There is a need to revise hospital formulary where low-potency steroids can also be included along with potent ones so that the latter can be avoided in conditions where they are unnecessary.

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Polypharmacy

Cited by 153 publications

References 40 publications

The Next Therapeutic Challenge in HIV: Polypharmacy

The Next Therapeutic Challenge in HIV: Polypharmacy

Rethinking Adherence: A Health Literacy–Informed Model of Medication Self-Management

Prescribing practices of topical corticosteroids in the outpatient dermatology department of a rural tertiary care teaching hospital

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