Dtsch Med Wochenschr 2021; 146(01): 15-22
DOI: 10.1055/a-1120-0779
Dossier

Polypharmazie – Was tun?

How to manage polypharmacia?
Heinrich Burkhardt

Bei der gleichzeitigen Verordnung mehrerer Arzneimittel sollte eine vernünftige Balance zwischen Risken und Nutzen gefunden werden [1]. So eindeutig eine inflationäre Polypharmazie problematisch erscheint, so eindeutig ist andererseits aber auch, dass eine Untertherapie vermieden werden muss [2]. Im Folgenden wird gezeigt, wie es gelingen kann, komplexe Situationen der Polypharmazie auf einer rationalen und individuellen Basis zu deeskalieren.

Abstract

Polypharmacia is a frequent challenge in modern medicine due to increasing complexity of both patients’ aspects in an ageing society – multimorbidity – and progress of therapeutic approaches. Although risks are clearly increasing with number of simultaneously prescribed drugs, neither analysis of the polypharmacia-problem solely by number nor focusing on deprescribing strategies by number alone is sufficient. The optimum of an overall risk-benefit ratio in the multimorbidity situation has to be described and put into practice by an individualized approach. Pattern analysis may help this, by identifying both the most vulnerable patients and polypharmacia-pattern with pronounced risk burden. Patient vulnerability depends significantly on functional abilities and prioritizing therapeutic goals in a comprehensive deprescribing process needs to implement stage of life and disease.



Publication History

Article published online:
04 January 2021

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