Full Definition

Polypharmacy is defined as the concurrent use of five or more medications, though some clinicians use a broader definition that includes any combination of drugs that exposes a patient to unnecessary risk. Among adults over 65, polypharmacy is extremely common — many seniors manage 8–12 medications from multiple prescribing physicians who may not be coordinating with each other.

Polypharmacy creates multiple risks. Drug-drug interactions can cause serious adverse effects. Many medications that are appropriate for younger adults are problematic in older adults (the Beers Criteria lists medications that should be avoided or used cautiously in elderly patients). The cumulative anticholinergic burden of multiple medications can impair cognition. Sedating effects of multiple drugs increase fall risk. Complexity of medication regimens leads to errors.

Medication review — a systematic evaluation of all a patient’s medications to identify unnecessary, harmful, or duplicative drugs — is a powerful intervention in geriatric care. Deprescribing (carefully reducing or stopping medications that are no longer appropriate) can improve both safety and quality of life.

For families transitioning a parent to a care setting, a full medication review by the facility’s pharmacist or physician is an important part of the admission process. Families should bring a complete, accurate medication list — including over-the-counter supplements and vitamins — to every care transition.