Preliminary results of a specialist pharmacist-led polypharmacy clinic for patients with prostate cancer

Medical advances offer the hope of bringing benefits to patients but also have the potential to do harm if not used appropriately.Knowing when and how to treat patients is particularly important in the prescribing of drugs as populations age and multi-morbidity becomes more prevalent.The challenge for clinicians is keeping up to date with new drugs as they come on the market and being aware of the interaction between them in patients being treated for a number of medical conditions.In an analysis of more than 300,000 patients, a Scottish study found that the mean number of drugs dispensed increased from 3.3 in 1995 to 4.4 in 2010.As the authors of this paper explain, this meant that the proportion of patients receiving 5 or more drugs increased from 12 to 22 per cent, and the proportion of patients receiving 10 or more drugs increased from 1.9 to 5.8 per cent.This matters because unless the drugs prescribed to patients are reviewed regularly by clinicians with up-to-date knowledge there is a risk that treatment may be ineffective at best and harmful at worst.A desire to increase awareness of the importance of polypharmacy prompted The King's Fund to commission this paper with the aim of bringing together what is known about this topic and to identify the implications for policy and practice.The Fund's interest derives from work on the care of people with long-term conditions and how this can be improved.Our brief to the authors was to review the evidence on polypharmacy and particularly to highlight how to optimise the contribution that medicines make to enabling informed patient choice and delivering desired outcomes for patients.viii