Polypharmacy and how to manage it

Unit 1: What is Polypharmacy?
This unit introduces the concept of polypharmacy, emphasising its prevalence and risks, particularly in patients over 65 years old. Participants will learn to distinguish between appropriate and problematic polypharmacy, recognising how physiological changes in older adults influence drug metabolism and toxicity. Key statistics illustrate the exponential risk of adverse drug reactions with an increasing number of medications. The session highlights the importance of balancing benefits versus harms when managing multiple medications.

Unit 2: Principles of Prescribing
Explore a systematic approach to prescribing new medications, focusing on minimising the risk of inappropriate prescriptions. This unit covers the importance of accurate medication lists, patient-specific factors, and potential prescribing cascades. Participants will learn how to evaluate treatment goals, assess medication adherence, and consider non-pharmacological alternatives. Practical strategies for avoiding adverse interactions and ensuring patient understanding of treatment plans are discussed.

Unit 3: Medication Reviews
This unit emphasises the critical role of medication reviews in reducing harm from polypharmacy. Learn when and how to conduct reviews, from brief in-consultation checks to thorough Domiciliary Medication Management Reviews (DMMRs). The process includes identifying unnecessary medications, simplifying regimens, and improving adherence. Practical tools like medication aids, technology reminders, and involving carers are discussed to support effective medication management.

Unit 4: Deprescribing Strategies
The final unit focuses on deprescribing as a systematic process to discontinue potentially harmful or unnecessary medications. Topics include overcoming common barriers, such as time constraints and patient hesitancy, and developing effective tapering strategies to minimise withdrawal symptoms. Special attention is given to high-risk medications commonly associated with adverse events in older adults. Participants will learn to communicate deprescribing plans effectively and monitor outcomes to ensure patient safety and satisfaction.

This course provides the knowledge and skills necessary to manage polypharmacy confidently, ensuring safe, effective, and patient-centred care.