14 Questions
What is inappropriate polypharmacy according to the National Institute on Aging?
The use of excessive or unnecessary medications
What is the main goal of optimizing polypharmacy according to the Scottish Government Polypharmacy Model of Care Group?
To ensure the patient's treatment is optimized to achieve their preferred outcomes
What is the definition of appropriate polypharmacy according to The King's Fund?
The prescribing of medicines for an individual for complex conditions or for multiple conditions in circumstances where medicines use has been optimized
What is the main factor to consider when reviewing polypharmacy according to The King's Fund?
The optimization of medicines use
What is problematic polypharmacy according to The King's Fund?
The prescribing of multiple medicines inappropriately, or where the intended benefit of the medicines are not realized
What is the role of clinicians in managing polypharmacy according to the Scottish Government Polypharmacy Model of Care Group?
To consider the patient's health goals and optimize medicines use
What is the purpose of the King's Fund's paper on polypharmacy and medicines optimization?
To outline the positive or negative potential of polypharmacy
What is the goal of combined knowledge in managing polypharmacy according to the Scottish Government Polypharmacy Model of Care Group?
To ensure the patient's treatment is optimized to achieve their preferred outcomes
What is the primary purpose of identifying specific stages in the polypharmacy process?
To provide triggers for appropriate polypharmacy
What is a characteristic of inappropriate polypharmacy?
One or more medicines fail to achieve the therapeutic objectives
What is a key aspect of appropriate polypharmacy?
The patient is motivated and able to take all medicines as intended
What is the primary reason for conducting medication review?
To optimize drug therapy to achieve therapeutic objectives
What is a consequence of inappropriate polypharmacy?
The patient is at an unacceptably high risk of adverse drug reactions
What is the primary goal of medication reconciliation at care transitions?
To ensure that all drugs are prescribed for the purpose of achieving specific therapeutic objectives
Study Notes
Polypharmacy
- Polypharmacy requires a combined effort from patients, clinicians, academics, and policymakers to manage and optimize patient treatment.
Appropriate vs Inappropriate Polypharmacy
- Inappropriate polypharmacy: the use of excessive or unnecessary medications, potentially harmful, or misaligned with the person's health goals.
- Appropriate polypharmacy: prescribing for an individual for complex conditions or multiple conditions with optimized medicine use and evidence-based prescribing.
The King's Fund
- An independent charitable organization working to improve health and care in England.
- Published a paper on polypharmacy and medicines optimization in 2013, highlighting the positive and negative potential of polypharmacy.
Definitions
- Appropriate polypharmacy: prescribing for complex conditions or multiple conditions with optimized medicine use and evidence-based prescribing.
- Problematic polypharmacy: the prescribing of multiple medicines inappropriately or where the intended benefit is not realized.
Scottish Polypharmacy Model of Care Group
- Identifies five stages for appropriate polypharmacy:
- Prescribing (and risk assessment)
- Medication review
- Dispensing and administration
- Communication and patient engagement
- Medication reconciliation (at care transitions)
Appropriate and Inappropriate Polypharmacy Criteria
Appropriate Polypharmacy
- All drugs are prescribed for specific therapeutic objectives agreed with the patient.
- Therapeutic objectives are being achieved or likely to be achieved in the future.
- Drug therapy is optimized to minimize the risk of adverse drug reactions (ADRs).
- The patient is motivated and able to take all medicines as intended.
Inappropriate Polypharmacy
- No evidence-based indication, indication has expired, or the dose is unnecessarily high.
- One or more medicines fail to achieve therapeutic objectives.
- One or multiple drugs cause unacceptable ADRs or put the patient at an unacceptably high risk of ADRs.
- The patient is not willing or able to take one or more medicines as intended.
This quiz explores the importance of managing polypharmacy in an aging population, distinguishing between appropriate and inappropriate use of multiple medications.
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