Polypharmacy

Polypharmacy is common among homebound older adults living with multiple chronic conditions and is associated with poor health outcomes. Polypharmacy often results from prescribing cascades, where an adverse effect of one medication is treated with another medication. Home-based medical care provides a unique opportunity to perform true medication reconciliation by reviewing medication bottles in the home and to create an accurate list of the medications a patient is taking, including over-the-counter medications. Careful medication review and assessing the patient’s home environment can help to identify potentially inappropriate medications and barriers to adherence. Polypharmacy can be reduced through deprescribing-the systematic process of discontinuing medications when the potential harms outweigh the benefits- with the goal of improving patient outcomes.