Medication Overload: An Overlooked Public Health Burden

Abstract

Polypharmacy, most commonly defined as the use of five or more medications concurrently, is associated adverse outcomes including increased risk of adverse drug events, medication nonadherence, drug-drug interactions, drug-disease interactions, hospitalizations and mortality (Masnoon et al, 2017; Quinn & Shah, 2017). There is no question that some people, particularly those with multiple chronic illnesses, need several medications in order to limit disease progression, control symptoms, improve function or extend life but excessive polypharmacy (i.e., ≥10 medications) or medication overload is a significant public health concern that is strongly associated with inappropriate medication use (Frank, 2014; Wahab, Nyfort-Hansen, & Kowalski, 2012; Quinn & Shah, 2017). In this paper, the terms medication overload and excessive polypharmacy are used interchangeably to describe the use of multiple drugs that pose a greater risk of harm than benefit with risks here referring to the use of medications that are likely to cause clinically significant drug-disease or drug-drug interactions while benefits referring to the effective management of the disease, delaying a disability outcome, slowing disease progression, and improving patient outcomes with fewer errors, if any (Lown Institute,2020; Quinn & Shah, 2017).