NR 601 Week 2 Polypharmacy Discussion Graded A - WEEK 2 – POLYPHARMACY DISCUSSION (INITIAL RESPONSE)
Polypharmacy is a common concern, especially in the elderly.
List the definitions of polypharmacy you encounter in yo
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NR 601 Week 2 Polypharmacy Discussion Graded A - WEEK 2 – POLYPHARMACY DISCUSSION (INITIAL RESPONSE)
Polypharmacy is a common concern, especially in the elderly.
List the definitions of polypharmacy you encounter in your assigned reading. Include an additional reference from an evidence-based practice journal article or national guideline.
As stated in the course textbook, polypharmacy has various meanings, which include prescribing many drugs, prescribing five or more drugs, or prescribing potentially inappropriate medications (PIMs); therefore, increasing the possibility for adverse drug reactions (ADR) within the older adult population (Kennedy-Malone, Plank, & Duffy, 2019). Individuals of the older adult population are the main consumers of medications; one-third of older adults take more than 5 prescribed medications, and approximately 20 percent take more than 10 prescribed medications (Kennedy-Malone et al., 2019). As previously mentioned, polypharmacy is common in the older adult population because of the high occurrence of chronic illnesses, such as hypertension, diabetes, arthritis, cardiovascular disease, heart failure, and renal diseases that frequently necessitate multiple medications for effective management. In another piece of literature, polypharmacy is defined as using 5 or 9 medications; however, others describe polypharmacy as taking a medication that does not have an indication for use, is ineffective, or is duplicating treatment provided by another medication (McGrath, Hajjar, Kumar, Hwang, & Salzman, 2017). According to Scott et al. (2015), many individuals may benefit from polypharmacy, which is described as greater than 5 prescription medications. However, polypharmacy increases the risk of ADRs in the older adult population because of the physiological changes involved with aging that modify pharmacokinetic and pharmacodynamic responses to medications (Scott et al., 2015).
Discuss three risk factors that can lead to polypharmacy. Explain the rationale for why each listed item is a risk factor. Risk factors are different than adverse drug reactions. ADRs can be a result of polypharmacy, and is important, but ADRs are not a risk factor.
• Increasing age is associated with a higher occurrence of chronic illnesses, and prescription medications are important in the management of those diseases. Due to some complex, chronic conditions, older adults are frequently prescribed multiple medications, which increases their risk for polypharmacy and ultimately increasing their risk of ADRs (Miller et al., 2017). Another aspect involving the aging older adult and polypharmacy is that of clinical practice guidelines. According to McGrath et al. (2017), the research involved in the development of clinical practice guidelines frequently excludes older adults and those with multiple comorbidities. Therefore, following treatment recommendations for multiple conditions and not individualizing the treatment plan could possibly lead to polypharmacy (McGrath et al., 2017).
• Polypharmacy can result from prescribing cascades, which occurs when an ADR is misunderstood as a new medical problem, leading to the prescribing of more medication to treat the initial drug induced symptom (McGrath et al., 2017). Potentially inappropriate medications, which are medications that should be avoided in older adults and in those
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