Rates of polypharmacy are going up in people over the age of 70, and pose risks to their health if not carefully monitored.

Polypharmacy refers to the use of multiple medications at once – usually thought to be five or more. Often it’s appropriate.  When someone has multiple chronic conditions that are being managed at the same time, it’s almost inevitable that they will have polypharmacy.

But in other cases it’s thought to be inappropriate – where it’s crept up slowly over time and health professionals aren’t aware of, or managing the interactions between all the different drugs someone is taking. That can lead to an increased risk of falls, hospitalisations, malnutrition and frailty. So how common is polypharmacy in Australia?

Taking data from the Pharmaceutical Benefits Scheme, researchers were able to look at drugs being prescribed to people over the age of 70. They followed trends in drug prescription and use over an 11-year period, from 2006 to 2017.

Though it was just a slice of data that they were able to access from the PBS, the researchers could extrapolate to get a representative picture of how older Australians were using medications.

They found that in 2017, almost a million Australians over the age of 70 were affected by polypharmacy – with women more likely to be using multiple medications than men. That number rose significantly between 2006 and 2017, but the rise is in part explained by Australia’s ageing population – more people reaching older ages.

What’s a more concerning figure is that the proportion of older Australians experiencing polypharmacy increased by nine per cent. These are conservative figures, too, because the researchers couldn’t take into account over-the-counter medications (including alternative medicines, which can interact with normal drugs).

Implications

When medications aren’t managed correctly, they can cause problems. In some nasty cases, people can get into a prescribing cascade, where drugs are prescribed to treat a side-effect produced by previous drug interactions and on it goes.

Keeping a list of the medications you take and why you take them, and continuity of care – seeing the same doctor or visiting the same practice for most doctor’s visits if you’re able – are useful ways of trying to reduce your risk of inappropriate multiple medication use.

Last Reviewed: 17/04/2020

© Norman Swan Medical Communications.


References

For reference: Page, et al (2019). Polypharmacy among older Australians, 2006–2017: a population‐based study. Medical Journal of Australia doi: 10.5694/mja2.50244.

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