Polypharmacy is an Indicator of Bad Practice and Low Quality in General Medicine
Journal Title: Journal of Quality in Health Care & Economics (JQHE) - Year 2019, Vol 2, Issue 4
Abstract
Quality indicators are increasingly used as a tool to achieve safe and quality clinical care. A significant number of them focus on drug therapy, but few address the problem of polypharmacy in general medicine. All patients, especially elderly patients, those with certain pathologies, those with multimorbidity, or those who live in institutions, are exposed to polypharmacy. The prescription of contraindicated or potentially inappropriate medications is also common. Although polypharmacy is sometimes unavoidable, this indicator has been associated with increased morbidity and mortality. The prevalence of polypharmacy is high, and could reach 20%. But, the main thing is that there is a great variability among general practitioners (GPs), which can vary from 4-5% until 18-30% according to GP, in the same geographical area and with lists of random and similar patients. Thus, the main cause of polypharmacy (of excessive use of drugs) is the professional; the prevalence of polypharmacy does not justify itself exclusively by the presence of the multimorbidity or of elderly people, neither is randomly distributed. Polypharmacy does not depend on the size GP' patients list (large lists may have little polypharmacy and small lists a lot of polypharmacy). It can be hypothesized that the presence of polypharmacy is an indicator of malpractice and poor quality of the general medical service, which should be used to improve the clinical care of patients. Therefore, it is imperative to monitor and optimize the use of medications in general medicine. This creates an opportunity to minimize adverse outcomes related to the use of medications and to improve the quality of care, possible cost savings and improve clinical outcomes. Additional research should deepen this proposal that high frequency of polypharmacy between different practices in general medicine is an indicator of poor quality of care in those GPs.
Authors and Affiliations
Turabian JL*
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