Polypharmacy, defined as taking 5 or more medications, is a growing issue among the elderly population. It carries significant health risks like adverse drug reactions and increased morbidity. The risks are higher in elderly patients due to age-related changes in metabolism and drug clearance. Common risk factors for polypharmacy include multiple chronic conditions, frailty, obesity, and poverty. As a nurse practitioner, interventions to prevent polypharmacy include assessing for drug interactions, reviewing medication lists for duplicates, adjusting dosages, and exploring non-pharmacological treatment options. Educating patients can also help reduce unnecessary polypharmacy.

1. Marie Germain
With the elderly population living longer, the rise of
polypharmacy is becoming more common. Polypharmacy, the
state of being in more than 5 medications causes high risk in the
health of the patient and consequently becomes a huge concern
for medical practitioners (Golchin, Frank, Vince, Isham &
Meropol, 2015). Polypharmacy is common among the elderly
people especially because of high morbidity factors. As a result,
it becomes medically necessary to be on multiple medications,
although it is not advisable especially given the high risk the
patient is put into. The question becomes does the benefits
outweigh the consequences? It is important to understand these
risks and possible interventions to prevent, treat and respond to
polypharmacy risks in order to improve patient outcomes.
Among the risk associated with polypharmacy are
reactions between drug to drug reactions and increased risk of
morbidity. Approximately 40% of the older adults are on
multiple prescription drugs, while half of these are at a high
risk of experiencing the risks associated with polypharmacy
(Rossi, Feske, Shaffer & Kreutzer, 2017). Reaction to drugs can
cause effects such as allergic reactions and other serious
adverse effects that can be fatal (Azhagesan, 2017). Also, drugs
may react with each other resulting in one having a greater
effect than the other, and possibly hindering it from the
intended action. Morbidity is the ultimate and most
unprecedented risk as death may occur on the patient following
immunity weakening.
As a health concern, practitioners need to respond to this
issue. The first response is to examine the patient’s accurate
medical history upon any given discharge. This is important in
examining previous medications and how they fared well with
the particular patient. This also helps to inspire the most
accurate medication (Rossi, Feske, Shaffer & Kreutzer, 2017).
Secondly, the medical practitioners need to reconcile

2. medications given to the patient (Azhagesan, 2017). This helps
to prevent the risk of drug to drug interactions, while adhering
to early intervention to help to prevent or deal with medical
issues.
Maritza Cosme
Risk Factors for Polypharmacy
Polypharmacy entails taking of 5 or more medicines.
Generally, polypharmacy in the elderly occurs because of three
factors: demographic factors, health factors, and access to
healthcare. It is more common among older patients and has
potential harms such as drug interactions and drug toxicity.
Polypharmacy is an area of concern for elderly because of
several reasons. Elderly people are at a greater risk for adverse
drug reactions (ADRs) because of the metabolic changes and
reduced drug clearance associated with ageing; this risk is
furthermore exacerbated by increasing the number of drugs
used. Polypharmacy is linked to increased risk of adverse drug
events in older people due to increased risk of drug interactions,
lack of adherence to medication regimes, susceptibility of older
people to side effects of medications, and physical changes
related to ageing causing difficulties in taking medications as
prescribed. One of the risk factors is frailty. Patients who are
frail are more likely to be having many health conditions that

3. can contribute to excessive polypharmacy. Another risk factor is
multimorbidity (Card, 2016; Ersoy, 2018). Patients who have
many chronic conditions may be have to take 5 or more
medicines to manage their conditions. Obesity is another risk
factor. Obese people may have risk factors for many health
conditions such as diabetes, heart disease, and high blood
pressure, among others (Ersoy, 2018). These conditions may
make them to take many medicines to manage them, therefore
resulting to polypharmacy. In the elderly, disorders that occur
as a result of ageing, frequently require treatment, resulting in
increased use of medications. Polypharmacy is common among
the elderly and although it can be therapeutic in nature, is
linked to adverse events such as falls.
Interventions to prevent polypharmacy and its complications
A nurse practitioner is central to the administration of
healthcare services. The nurse can play certain roles to prevent
polypharmacy and its complications. One intervention may
entail assessing for drug-drug interactions. If there are
interactions, there may be a need to eliminate some medicines.
Another intervention may include reviewing dosages. The
effects of the medicines may be due to excess dosages. The
reviewing of dosages can lead to a reduction in the number of
medicines that one takes. Another intervention is eliminating
duplicate medications (Johansson, 2017). Some medications
may serve the same purpose; and therefore, it is necessary to
eliminate some to reduce the burden on the patient. Exploring
non-pharmacological approaches may also be necessary. For
instance, if a patient has depression or anxiety, use of
psychotherapy and exercise may be a useful alternative to
medicines and therefore reduce the number of medicines that
one takes.

4. Guillermo
Polypharmacy
Indeed, polypharmacy in which patients take several medicines
to an extent that they result in complexities is a common
experience among the old people. Such a situation is as a result
of particular aspects which is discovered can solve the issue.
The common risk factors for polypharmacy among the older
individuals are gastric disturbances as well as gastrointestinal
diseases that induce a lot of adverse reactions which make
patients opt to taking gastrointestinal drugs. The intake of such
drugs them result in cascading of treatments and increment in
DDC. Additionally, painful conditions which the older adults
suffer including arthropathic, chronic, and neuropathic pain.
According to Word Health Organization (2019) chronic pain is
related with behavioral and somatic comorbidities encourages
the old adults to consume excess analgesic. Indeed, risk factors
such as the ones mentioned above trigger the increased cases of
polypharmacy.
As a Nurse Practitioner, I would proactively teach the
community especially old patients about sustainable and
suitable medication as well as lifestyle. According to WHO
(2019) unhealthy lifestyle causes multimorbidity among many
patients, hence educating the ole people on healthy foods,
proper health care, and housing as well as exercising helps
reduce polypharmacy and its effects. The second intervention is
to involve the patients into understanding the effect of using too
many medications, reporting side effects immediately they
happen, and using medication in the correct manner. Molokhia
& Majeed (2017) Opines that involving patients in the process
of medication, monitoring them as they start and continue using
the medication, as well as informing them on the right way to
take drugs and report on impacts serves in reducing risks of
polypharmacy. Therefore, the two interventions would suit me
well.

5. Daylamis
Risk Factor for Polypharmacy
Polypharmacy may lead to comorbidities mostly to elderly
people since its strongly related to age. Most of the aged people
suffers from multiple illness at the same time leading to the
taking more than one medication to cater for different sickness
(Cantlay, Glyn, & Barton, 2016). Patients with multiple
comorbidities have a high risk of polypharmacy since treating
the patient with various illnesses has become a general practice
in the health sector. In addition, most of the clinical officer’s
focus on the single disease at a time, excluding patients with
multiple conditions.
Polypharmacy increases the risk of poor behavior and
misunderstanding on medication to the patient. Most of the
patient lack proper knowledge of drugs and reliable on available
information or experience. This led to duplication or
unnecessary medication prescribed by medical staff who have
no previous medical history of the patient. The patient also
accesses medication from multiple providers that do not know
his other health condition.
Intervention to Prevent Polypharmacy

6. First is through identify the indication strategy that should be
implemented by any therapist and physician. The approach
involves identification or diagnosis before the medication is
given out to avoid the increased case of misappropriating
prescriptions in healthcare facilities (Fasipe, Akhideno,
Ibiyemi-Fasipe, & Idowu, 2018). It also the role of the patient
to ensure the information given is clearly communicated and in
the direction of use.
Another method is the integration of START (screening tool to
alert the doctor to the right treatment) technology in health care
facilities. The technology provides the physician with an
opportunity to evaluate and discontinues any prescribed
medication that poses a risk to polypharmacy.
Dailyn Gonzalez
Advanced Pharmacology
Polypharmacy refers to the use of more than one medication by

7. a patient. The exact number of medications that define
polypharmacy vary from one person to another and ranges from
five to ten drugs. There are various risk factors associated with
the condition. The first one is age. Polypharmacy is common in
old people. The elderly are more susceptible to experiencing the
condition since they have multiple diseases which require
varying prescriptions. The elderly are also at risk since their
bodies have high chances of experiencing drug events as a
result of metabolic changes and a reduction in drug clearance
capabilities (Abdulraheem, 2013).
According to Slater, White, Venables, & Frisher (2018), another
risk factor associated with polypharmacy is poverty or lower
wealth. People from lower social classes tend to use over the
counter drugs to treat themselves due to lack of funds to take
them to hospitals. As a result, they take more than one
medication for their conditions. Obesity is also believed to
increase the risk of polypharmacy. Obesity is usually associated
with a series of chronic heart diseases such as hypertension.
Therefore, obese people use multiple medications to treat
various diseases.
The first intervention towards preventing polypharmacy
involves drawing from palliative care. The intervention is
mostly applicable in very old people, and it entails
discontinuation of drugs being administered on the patient.
Another method entails conducting medication training during
transition care. An example of a transition case is discharging a
patient. Duplicate medications also need be to eliminated
(Dagli, & Sharma, 2014). The last method entails assessing a
patient for the presence of drug-drug interactions before
administering any medication. Therefore, as a practitioner, the
interventions which I would take to prevent polypharmacy
include training patients before they are discharged and
assessing them for drug-drug interactions before administering
medications.

8. Maylee
Polypharmacy
Some of the definitions concerning polypharmacy that can be
encountered in my readings can be more than one definition
aspect. The first description of polypharmacy is the utilization
of numerous pharmacies, which is a chief public health concern.
This happens as the multiple prescribers in the industry, the
ever readily available of supplements, and the use of OTC
medications are some of the experienced challenges affecting
the prescription for the aged population ( Chamberlain College
of Nursing, 2018). Secondly, numerous prescribers, as well as
care providers, the use of OTC drugs, the cost adherence, the
availability of supplements as well as the herbals, are still
problems affecting the prescriptions for the adults (Terrery &
Nicoteri, 2016). Moreover, the use of several medicine drugs is
what is referred to as polypharmacy, which usually affects the
older population experiencing multi-morbidity, results as one or
more medicine drugs can be employed as a therapeutic modality
to treat each condition experienced (Masnoon, Skakib, &
Caughey, 2017).
The self-medication is a risk factor which contributes to the
polypharmacy in most of the cases. The primary rationale here
is evidenced based on that most of the patients usually buy
medicine from the nearest local places as they do self-

9. prescriptions and purchase, and this increases the risk factors of
polypharmacy. Moreover, due to the rising status of the
economy and the escalation of the cost of medicinal drugs the
patients are often like to use the medicines that had been
prescribed for them in the past and this enhances the risks of
polypharmacy as a result of the self-medications (Maher,
Hanlon, & Hajjar, 2014),
The aspect of chronic comorbidities is a risk factor that results
in the use of polypharmacy. For example, if the patient has been
diagnosed with conditions such as diabetes, cancer, dementia,
cardiorespiratory illness, infectious diseases, these patients are
likely to be subjected to polypharmacy. Sometimes, when
patients have different care providers with separate chart sheets,
they are likely to subject the patient to polypharmacy (Maher,
Hanlon, & Hajjar, 2014).
Some of the interventions that I can take as nursing practitioner
is enhance a comprehensive review of the patient treatment
sheet to avoid an element of medication duplicate which might
occur during the transmission of the patient from one facility to
another one or even correctly check the information given to the
patient by the chemist to avoid polypharmacy issues. The brown
bag review technique is the strategy where the patient is
encouraged, carrying all medical history to allow the
comprehensive review to prevent the element of subjecting the
patient into polypharmacy (McGrath et al., 2017). Another
intervention strategy is to create a thorough follow up with the
patients. The planning aid at the time of doing a prescription of
medication as it provides a complete developed plan to monitor
and assess the patient regularly. The comprehensive follow up
method enables the patient to understand the effects and
symptoms that may results due to medication withdrawal as it
provides the necessary, which can cause the return of the
condition if the medication is not taken as per the prescription.