PolypharmaciaY57.-!; Y57.9!

Simultaneous intake of 5 or more prescription or non-prescription drugs. Polypharmacy is often associated with multimorbidity. It is facilitated by inaccurate indications, inadequate medication planning and insufficient consultation between the parties involved: patients/relatives/physicians/pharmacists. The frequency of polypharmacy is increasing worldwide, even in emerging and developing countries. This is partly due to increasing life expectancy and partly due to the increasing number of people who have access to medicines.

Another definition of polypharmacy is: the prescription of more drugs than clinically indicated and/or a regimen with at least one unnecessary drug.

According to a survey conducted by a health insurance company (Barmer) in 2016, almost 12.5% of all insured persons were prescribed 5 or more active ingredients over at least one quarter and therefore fulfilled the criterion of polypharmacy. Over 3 quarters, this applied to 5% of all insured persons. Around 36% of all over 65-year-olds receiving medication are "cumulative polypharmacy", defined as a prescription of 5 or more active ingredients within one quarter. The proportion of older patients who do not follow doctors' orders for pharmacotherapy is around 20-50%.

Inventory of medication intake and medication assessment: checking the appropriateness of prescriptions.

Optimizing the medication process: In order to optimize and ensure the safety and quality of drug therapy, the entire prescription process should be considered, with the following steps that are run through cyclically:

Inventory: medical history including medication history

Medication assessment: critical review and evaluation of medication

Consultation with the person being treated about their needs and ideas on drug therapy

Prescription suggestion: therapy modification, discontinuation attempts, etc.

Communication: informing the patient/relatives

Monitoring (examination of treatment results, recording of adverse drug reactions - ADRs).

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