In the U.S., polypharmacy affects an estimated 65% of adults 65 and older. As the population ages and the prevalence of chronic conditions rises, more patients are prescribed multiple medications to manage their health. While these treatments are often necessary, polypharmacy increases the likelihood of additional health risks. Without proper oversight, patients may experience unnecessary side effects, reduced quality of life, and even avoidable hospitalizations due to medication-related complications.
For pharmacists, addressing polypharmacy is a critical aspect of patient care. To address health risks and prevent adverse health events, health plans partnering with pharmacists can utilize medication therapy management (MTM) programs to provide a structured approach to reviewing and optimizing medication regimens, ensuring that each prescription is necessary, effective, and safe.
Polypharmacy is commonly defined as the concurrent use of multiple medications by a single patient, typically five or more. While it’s often necessary for managing chronic conditions, polypharmacy presents significant challenges for both patients and healthcare providers–particularly pharmacists who play a critical role in ensuring medication safety and effectiveness.
In clinical practice, polypharmacy is not inherently problematic. For example, a patient with diabetes, hypertension, and heart disease may require multiple medications to achieve optimal health outcomes. However, concerns arise when unnecessary, duplicative, or inappropriate medications are prescribed, increasing the risk of adverse drug events (ADEs), medication nonadherence, and drug interactions.
Pharmacists frequently encounter two primary forms of polypharmacy: appropriate polypharmacy and problematic polypharmacy. Appropriate polypharmacy refers to the evidence-based use of multiple medications that effectively manage a patient’s conditions with minimal risk. In contrast, problematic polypharmacy occurs when patients take medications that may no longer be necessary, interact harmfully, or contribute to medication overload. This issue is particularly prevalent among older adults and individuals with complex medication regimens, where deprescribing strategies may be necessary to optimize therapy.
Given the increasing prevalence of polypharmacy, especially among aging populations and those with multiple chronic conditions, pharmacists must take an active role in medication therapy management to mitigate risks, improve medication adherence, and enhance patient outcomes. Through comprehensive medication reviews (CMRs), drug interaction screenings, and collaboration with prescribers, pharmacists can help ensure that polypharmacy remains beneficial rather than burdensome.
While polypharmacy is often necessary for managing chronic conditions, it introduces several risks that can negatively impact patient outcomes. Pharmacists, particularly those engaged in MTM programs, play a crucial role in identifying and mitigating these risks to ensure medication regimens remain safe, effective, and appropriate.
Key risks of polypharmacy include:
These polypharmacy-related risks directly influence patient health, healthcare utilization, and long-term outcomes. Without proper oversight, excessive medication use can lead to a cycle of prescribing cascades–where additional medications are prescribed to manage the side effects of existing ones–further exacerbating the issue.
With these risks ever prevalent, it’s critical that patients learn how to appropriately manage their medications. However, that’s more likely to be accomplished with the help of pharmacists and through MTM programs. As frontline medication experts, pharmacists leverage MTM services to identify and resolve medication-related problems, enhance medication adherence, and improve overall patient outcomes.
With MTM programs, pharmacists are equipped to address polypharmacy risks by implementing effective medication management strategies.
CMRs are the cornerstone of MTM and provide pharmacists with an opportunity to assess a patient’s entire medication regimen. Through a structured review, pharmacists can:
Unlike CMRs, which are comprehensive, TMRs focus on specific medication-related concerns, such as high-risk drugs, adherence issues, or recent hospitalizations. By conducting regular TMRs, pharmacists can intervene promptly to prevent ADEs and optimize treatment.
MTM provides a structured approach for deprescribing unnecessary or high-risk medications, particularly in older adults or patients with multiple chronic conditions. By collaborating with prescribers, pharmacists can:
Many patients are unaware of the potential dangers of taking multiple medications or may struggle with adherence. Through MTM, pharmacists can educate patients on proper medication use, potential side effects, and the importance of adherence while addressing concerns about cost, lifestyle adjustments, or adverse effects. By empowering patients to take an active role in managing their medications safely, pharmacists help improve adherence and reduce the risk of medication-related complications.
Another crucial role of MTM is fostering collaboration with healthcare providers to ensure prescribing decisions are evidence-based and patient-specific. By communicating directly with prescribers and other healthcare professionals, pharmacists can prevent prescribing cascades, where new symptoms are mistaken for new conditions rather than side effects of existing medications. Additionally, MTM supports transitions of care, such as post-hospitalization medication reconciliation, to minimize readmission risks.
By integrating MTM into patient care, pharmacists help minimize the risks of polypharmacy while ensuring that medications contribute positively to health outcomes. Some key benefits include:
However, managing polypharmacy effectively requires pharmacists to have access to the right tools and technology. A comprehensive pharmacy services platform, such as Alliance by Aspen RxHealth, empowers pharmacists with advanced clinical decision support, real-time medication data, and streamlined workflows to enhance MTM delivery.
These platforms facilitate CMRs, TMRs, and seamless collaboration with prescribers to ensure that medication regimens are safe and necessary. By leveraging technology-driven insights, pharmacists can quickly identify high-risk medications, detect potential drug interactions, and recommend deprescribing strategies where appropriate.
Plus, these platforms improve efficiency and scalability for pharmacists and health plans. With features like automated documentation, secure patient communication, and integrated adherence tracking, pharmacists can spend less time on administrative tasks and more time on direct patient care. Additionally, access to real-time claims data and medication history allows pharmacists to make more informed decisions and intervene before medication-related issues escalate.
MTM isn’t just about managing medications. Rather, it’s also about managing medication safety and effectiveness. By incorporating a technology-enabled approach to MTM, pharmacists can enhance patient engagement, improve medication outcomes, and drive better overall healthcare efficiency. With platforms like BeWell with Aspen RxHealth and for in-house teams, Alliance by Aspen RxHealth, pharmacists are equipped with the tools they need to proactively address polypharmacy risks, optimize therapy, and ultimately improve patient health.
To learn more about how Aspen RxHealth can help pharmacists and health plans deliver high-quality care to patients, get in touch today to book a demo!