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NHS Scotland created a comprehensive site regarding medication management which they refer to as polypharmacy guidance. http://www.polypharmacy.scot.nhs.uk/7-steps/
An example of their content follows. They even have an app for smartphones.
Step1: Identify aims and objectives of drug therapy
Review diagnoses and identify therapeutic objectives with respect to:
- Management of existing health problems.
- Prevention of future health problems.
No real surprises.
From the abstract:
“Results indicate an increase in overall use of prescription drugs among US adults between 1999-2000 and 2011-2012 with an estimated 51% of US adults reporting use of any prescription drugs in 1999-2000 and an estimated 59% reporting use of any prescription drugs in 2011-2012 (difference, 8% [95% CI, 3.8%-12%]; P for trend <.001). The prevalence of polypharmacy (use of ≥5 prescription drugs) increased from an estimated 8.2% in 1999-2000 to 15% in 2011-2012 (difference, 6.6% [95% CI, 4.4%-8.2%]; P for trend <.001). These trends remained statistically significant with age adjustment. Among the 18 drug classes used by more than 2.5% of the population at any point over the study period, the prevalence of use increased in 11 drug classes including antihyperlipidemic agents, antidepressants, prescription proton-pump inhibitors, and muscle relaxants”