Background and importance Polypharmacy is defined as taking more drugs than are clinically necessary and is associated with an increased risk of adverse effects, interactions, less adherence to treatment, more hospitalisations and increased costs. Hence treatment review is important, which allows for a better benefit–risk ratio in the use of medications.
Aim and objectives To analyse the modifications that have been made to polymedicated patients’ treatment after review.
Material and methods A cross sectional study was conducted in polymedicated patients (15 or more active prescriptions) selected in a health management area during December 2019. Reviews were carried out by primary care physicians who were previously sent lists with the identifying data of the assigned patients. The pharmacy service held sessions on the strategy to perform to carry out these reviews. Demographic data, associated pathologies and treatment modifications were collected. Deceased patients were excluded.
Results 626 patients were selected in the cross sectional study, 72.5% (454 patients) were reviewed and of these, 22 patients were excluded due to death. 38.4% (166) were men and 61.6% were women (266) with a mean age of 75 years. 55.1% were 75 years or older. Regarding associated pathologies, 91.4% had heart disease, 63.0% diabetes mellitus, 63.9% dyslipidaemia, 45.6% respiratory disease (asthma/COPD), 30.1% chronic kidney failure, 25.7% atrial fibrillation, 43.3% had a mental health episode and 10.6% were oncological. Regarding the number of active prescriptions, 371 patients (85.9%) had 15–19 prescriptions, 56 patients (13.0%) had 20–24, and 5 patients (1.2%) had more than 25 prescriptions. Modifications were made in 30.1% of patients: a drug was withdrawn in 87 (20.1%) patients because it was unnecessary, in 3 patients (0.7%) due to adverse effects, in 8 patients (1.9%) due to therapeutic duplication and in 6 (1.4%) due to drug interactions. 20 (4.6%) patients experienced a change in drug dose, 3 (0.7%) patients had the drug changed and 3 (0.7%) had a new drug added.
Conclusion and relevance Despite the low number of modifications made, review of polymedicated patients may be useful in our health management area. Most patients treated with more than 15 drugs are over 75 years of age with multiple pathologies, so reduction of prescriptions may help patient safety and improve adherence, which in turn may increase the efficiency of the sanitary system.
Conflict of interest No conflict of interest