Polypharmacy can be appropriate and beneficial for patients. However, polypharmacy also increases the risk of problematic prescribing and is associated with adverse health outcomes. Two “golden rules” which reduce problematic prescribing are to always enquire if patients are taking their medicines as prescribed, and to never assume that all of the medicines a patient is taking are known. Prescribers can take further steps to reduce problematic prescribing by being clear about the goals of care, adopting a systematic approach to new prescribing, being aware of medicines and conditions commonly associated with adverse outcomes and identifying patients at high risk of being affected by problematic prescribing, e.g. patients taking ten or more medicines simultaneously. Medicine reviews should be periodically conducted for all patients with multiple long-term conditions.
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