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Michelle Hersey

on 19 November 2013

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Transcript of Polypharmacy

The Cost of Polypharmacy
The United States Spends...
$133 billion on medication
$177 billion on drug-related problems

For every $1 spent on drugs, $1.33 is spent managing complications of drug therapy!
Considerations in Alzheimer's Disease
Use of acetylcholinesterase inhibitors (Exelon, Reminyl, Aricept) with anticholinergic agents --> negative effects on Alzheimer's therapy

Acetylcholinesterase inhibitors with antipsychotics or benzodiazepines --> increased adverse effects
What is polypharmacy?
A growing health concern
More medications are prescribed than are clinically warranted
Greatest risk:
Multiple medical disorders
Multiple physicians
Multiple pharmacies
Recent hospitalization

Polypharmacy is NOT
A quota on the number of medications prescribed currently.

For some, 1 medication may be too much and for others, 15 medications may not be enough.
Risk Factors for Polypharmacy
Recent hospitalization
Underlying medical conditions
Gender - male
New resident to nursing home
Prevention Strategies
Patient reporting of all drugs and symptoms

Say NO to drugs whenever possible

Start LOW and go SLOW when increasing dose

Adequate/appropriate monitoring

Knowing the drug, potential interactions,and clinical status of the patient

Thorough med history and drug assessment
Provide the right number of medications for that individual.

Identify opportunities to eliminate unnecessary or potentially harmful drugs while adding drugs needed to ensure optimal therapeutic outcomes.
Multiple prescribers
Multiple pharmacies
High-risk medications
Number of medications
Combination of products
Limited drug knowledge
Inadequate monitoring
Both patient and physician factors result in over-prescribing of drugs
Polypharmacy is not a new concept.

Ensure that drug therapy is appropriate:
Address misuse and overuse
Add appropriate therapy to correct underuse
Simplify regimens as much as possible

All drug therapy must be individualized.

Strengthen relationships with patients and prescribers.
Full transcript