Hypothesis and practices to avoid polypharmacy in family medicine
Published on: 2019-12-09
The basic concept of the use of multiple medicines (polypharmacy) is quite simple: the prescription of more medications than are clinically appropriate.The incidence of drug-drug interactions (DDIs) increases with the number of drugs used, with prevalence and incidence of clinically observable DDIs is between 5- 25% of patients on pharmacological treatment. DDIs also contribute substantially to differences in drug response. DDIs are the source of adverse drug reactions (ADRs). 10 % of ADRs are due to DDIs. The use of 5 drugs used chronically is a figure from which there is an independent relationship with the inappropriate use of medicines: the frequency of ADRs is 6% when a patient takes two medications, 50% when he takes five, and almost 100% when he takes eight or more medications. In this scenario, it could be hypothesized that the presence of polypharmacy is an indicator of malpractice and poor quality of family medicine service. Thus, some techniques could be suggested for judiciously avoid polypharmacy in family medicine: 1) Use drugs only in authorized indications; 2) Use only indicated drug combinations; 3) Avoid starting treatment with two drugs from the same drug group; 4) avoid using the last commercialized drug, of which there is almost no experience; 5) Avoid using higher doses than indicated at the beginning of prescription; 6) Avoid using a drug longer than indicated, and 7) Not treating ADRs with other drugs.
Polypharmacy; Sanitary Attention; Multimorbidity; Inappropriate Prescribing; Family Medicine; Framework; Teaching.