Medication Management in Patients with Polypharmacy

Rehabilitation patients have complex conditions often requiring multiple medications. The term “polypharmacy” represents a well-known risk for those taking multiple medications. Polypharmacy, however, is more than duplications, overuse, or insufficient doses. In fact, there are over 130 published definitions of polypharmacy, as identified by Masnoon et al. (2017). Generally, the concept means taking five or more medications; however, such a definition does not take into account comorbidities and the safety and efficacy of drug combinations. The following is a case study that exemplifies the need to review medication lists beyond drug numbers and dosages. In addition, medications to help one condition can be contraindicated for treating another health issue. Evidence-based (and commonsense) practice requires comparisons and follow-up to identify inconsistencies, contraindications, and even the need for additional medications. Ironically, even more “polypharmacy” may be indicated when there are comorbidities. Usually, nurses perform medication reviews at every appointment, admission, or home visit. Beyond medication safety concerns, rehab nurses, in particular, recognize how quality of life can be compromised when medication problems exist.