Navigating Polypharmacy: A Patient-Focused Guide to Safer Medication Use

Polypharmacy, commonly defined as the use of 5 or more medications, is increasingly prevalent, particularly among older adults and patients living with multiple chronic conditions.¹ Although pharmacotherapy is essential for disease management and improved quality of life, complex medication regimens are associated with an increased risk of adverse drug events, clinically significant drug-drug interactions, medication nonadherence, and hospitalizations.² From a patient-centered care perspective, pharmacists play a critical role in helping patients safely navigate polypharmacy through education, routine medication reviews, and collaboration with the broader health care team.

Understanding Polypharmacy and Its Risks

For many patients, managing multiple medications can be challenging and overwhelming. Complex dosing schedules, look-alike or soundalike drug names, and frequent changes to therapy increase the risk of missed doses, therapeutic duplication, and inappropriate medication use. Polypharmacy has been associated with negative clinical outcomes, including falls, cognitive impairment, frailty, and increased emergency department visits, particularly in older adults.^1,2

However, polypharmacy should not be viewed as inherently inappropriate, as the use of multiple medications is often clinically necessary to achieve optimal disease control. Many patients rely on combination therapy to effectively manage chronic conditions, including cardiovascular disease, diabetes, and mental health disorders. Polypharmacy becomes problematic when medicationslackanappropriateindication,offer limited ongoing benefit, or pose an unfavorable risk-benefit profile. Pharmacists are well positioned to help patients understand these issues and optimize therapy.

Educating Patients to Improve Medication Safety

Patient education is a fundamental component of effective polypharmacy management. Patients should be encouraged to understand the name, purpose, dosage, and timing of each medication they use, including OTC products and dietary supplements. In addition, herbal products, vitamins, and as-needed medications are frequently overlooked yet may contribute to clinically significant drug interactions.³

Pharmacists can enhance patient understanding by using clear, nontechnical language and verifying comprehension through teach-back techniques. Additional interventions such as providing written medication lists, recommending pill organizers, and suggesting mobile reminder tools can further improve adherence and strengthen patient confidence.

The Role of Comprehensive Medication Reviews

Routine medication reviews, including comprehensive medication management and medication therapy management, are essential for identifying potentially inappropriate medications and aligning medication regimens with patient-specific goals. During these reviews, pharmacists evaluate each medication for appropriate indication, effectiveness, safety, and adherence.⁴

From the patient’s perspective, medication reviews offer an opportunity to discuss adverse effects, cost concerns, and adherence challenges. Encouraging patients to bring all prescription medications, OTC products, and dietary supplements to appointments (a practice commonly referred to as a brown bag medication review) helps ensure an accurate and complete medication profile.

Deprescribing as a Patient-Centered Strategy

Deprescribing is a structured, clinician-guided process of tapering or discontinuing medications that no longer provide clinical benefit or pose potential harm.⁵ When approached collaboratively, deprescribing can improve clinical outcomes and quality of life without compromising disease control. Patients may interpret deprescribing as a reduction in care rather than a component of medication optimization. Pharmacists play a role in reframing deprescribing as an evidence-based approach focused on safety and individualized treatment. Shared decision-making, clear communication, and close follow-up are essential to the success of deprescribing interventions.

Improving Communication Across the Health Care Team

Fragmented care is a key contributor to inappropriate polypharmacy, as patients often receive prescriptions from multiple prescribers, increasing the risk of therapeutic duplication and clinically significant drug-drug interactions. Encouraging the use of a single pharmacy when feasible allows pharmacists to more effectively monitor medication therapy and identify potential medication-related problems. Patients should also be encouraged to maintain an up-to-date medication list and present it at each health care encounter. Effective communication among pharmacists, prescribers, and patients is essential to improving care coordination.

Addressing Cost and Adherence Barriers

Medication cost is a common barrier to adherence and is frequently underreported by patients. In response, some patients may skip doses, split tablets, or discontinue therapy without notifying their health care providers. Creating a supportive, nonjudgmental environment encourages patients to openly discuss financial concerns. Pharmacists can help mitigate cost-related barriers by identifying lower-cost therapeutic alternatives, simplifying medication regimens, synchronizing refills, and connecting patients with medication assistance programs. These efforts can improve adherence while strengthening patient trust and engagement.

Advocating for Patients as a Pharmacist

Pharmacists play an important role in helping patients manage complex medication regimens. Through patient education, routine medication reviews, appropriate deprescribing, and collaboration with prescribers, pharmacists help ensure that medications are necessary and used safely and effectively. When patients view pharmacists as accessible sources of medication information, they may feel more comfortable asking questions and participating in their care. Strong pharmacist-patient relationships can help reduce confusion and support safer medication use for individuals managing chronic conditions.

REFERENCES

1. Maher RL, Hanlon J, Hajjar ER.Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014;13(1):57-65. doi:10.1517/14740338.2013.827660

2. 2023 American Geriatrics Society Beers Criteria UpdateExpert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372

3. Medication safety in polypharmacy: technical report. World Health Organization. June 20, 2019. Accessed January 13, 2026. https://www.who.int/publications/i/item/medication-safety-in-polypharmacy-technical-report

4. The importance of reviewing medications with a health care provider. HumanCare. May 2, 2025. Accessed January 13, 2026. https://www.humancareny.com/blog/the-importance-of-reviewing-medications-with-a-healthcare-provider

5. Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175(5):827-834. doi:10.1001/jamainternmed.2015.0324