Why you should question
your medication list regularly
According to the recommendation from smarter medicine / Choosing Wisely, medications should only be taken when truly necessary, due to possible side effects and interactions. The expected benefits should outweigh the potential risks. Medication lists should be reviewed regularly to prevent and minimize polypharmacy. Find out what this means for you.
What is polypharmacy?
Polypharmacy refers to the regular use of five or more different medications. This includes not only tablets, but all forms of medication (injections, creams, drops, sprays, etc.). Polypharmacy can be problematic as it may increase the risk of negative effects on your health.
Who is affected by polypharmacy?
Polypharmacy affects all persons who regularly take five or more different medications. As people age or develop chronic conditions, the number of medications tends to increase. Being treated by multiple physicians can also raise the risk of polypharmacy. During a hospital stay or an acute illness, additional medications are often prescribed, but these are usually not meant to be taken long-term.
Polypharmacy
should be avoided …
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… due to drug interactions.
… because health insurance does not cover the costs.
Polypharmacy does not need to be avoided because of cost coverage. Whether health insurance covers the cost of a prescribed medication does not depend on the number of medications.
… due to the increased risk of side effects.
… to keep treatment as simple as possible.
I review my medication with my primary care provider at least once a year. Together, we adjust it based on my health, my preferences and goals, and the latest scientific findings. We also reassess whether the benefits still outweigh the risks.
The role of the primary care provider in polypharmacy
Being treated by multiple physicians (e.g., primary care provider, cardiologist, pulmonologist) increases the risk of polypharmacy. Therefore, it is important for one physician to keep an overview of all the different medications. Sometimes, certain medications may not be compatible with other ones. Ideally, this is best handled by the primary care provider.
Role of
medication lists
As a patient, you can help prevent polypharmacy as well. Bringing your current and updated medication list to every consultation enables physicians to find the best treatment options for you and to minimize potential side effects. Additionally, the medication list gives you a clear overview of your medications.
Advantages and
disadvantages
… of questioning your medication
Reducing interactions
Reducing side effects
Reducing costs
Increased quality of life
Complications from stopping medication without proper consideration
Withdrawal symptoms from stopping medication incorrectly
Uncertainties about your own health
Symptoms may return if
a medication is stopped carelessly
In emergency situations, it is incredibly valuable when patients bring an up-to-date and accurate medication list with them. It helps me better assess their symptoms and prescribe any necessary new medications with more confidence.
FAQ
Are vitamins, dietary supplements, and herbal remedies considered medications?
Yes, as they fall under the Therapeutic Products Act and belong to the medicinal products and devices. They can interact with other medications just like conventional medications and may cause side effects as well.
What are the problems associated with polypharmacy?
The more medications a person takes, the higher the risk for side effects. Interactions between medications become more complex, which can lead to certain (side) effects being intensified or diminished.
This also applies to over-the-counter medications, herbal remedies, dietary supplements, and vitamins. In addition, the risk for not following the treatment plan increases. Especially in older patients, the benefits of a medication must be carefully weighed against its impact on quality of life and life expectancy.
Of course, there are situations where the need for multiple medications outweighs the risk of polypharmacy.
Are there any downsides to following the recommendation to critically review my medication?
The main downsides result when critical reflection leads to stopping medications without proper consideration. If medications are discontinued carelessly and without evaluating their benefit, complications can occur. On the one hand, symptoms that were controlled by the medication may return. On the other hand, certain medications (e.g., sleeping pills, antidepressants) can cause withdrawal symptoms if they are stopped abruptly. However, if a medication can be discontinued and this is done correctly, e.g. by slowly tapering, such effects can be avoided. That is why you should never stop taking a medication on your own without first discussing with your treating physician.
Summary
Never stop taking medications without talking to your physician before. Review your medication at least once a year or whenever you receive a new diagnosis or medication. You can use our step-by-step instructions to do this. A good understanding of your medication benefits your health. Keeping a well-maintained medication list is beneficial for everyone involved. Remember that every medication can have risks and side effects that you should be aware of.
Inform your primary care provider if you would like to discuss your medication. Discuss whether certain medications could be discontinued and how this should be done.
Downloads & further information
Discussion with your
primary care provider
Always discuss your thoughts, questions or uncertainties with your primary care provider. If possible, try to go to the appointment well-informed and prepared.