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Internal Medicine

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Polypharmacy, which is defined as regular use of five or more medications, increases the risk of adverse medical outcomes.


Patients who take five or more medications can find it difficult to understand and adhere to the complicated regimens.

Risk factors for polypharmacy include having multiple medical conditions that are managed by multiple specialist or subspecialist physicians, residing in a long-term care facility, having poorly updated medical records, and using automated refill services. Inappropriate prescribing of drugs that are not discontinued after their usual effective or recommended period is known as legacy prescribing and can contribute to inappropriate polypharmacy.

According to the Choosing Wisely campaign, any prescriptions beyond a threshold of five medications should trigger a thorough review of the patient’s complete regimen, including over-the- counter medications and dietary supplements, to determine if any of the medications can be discontinued. Tools such as the Beers criteria list and the Medication

Appropriateness Index can be used to identify potentially inappropriate medication use, but no single tool or strategy has been determined to be superior. If discontinuation of particular high-risk medications is not possible because of medical conditions, then dose reductions should be considered.

Ayham Alagha
Mazen Kherallah
S H
M I

Thank you for posting, as I do not work in an outpatient setting, I am not familiar with BEERS criteria, would anyone enlighten me on it? @Everyone

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