Polypharmacy: Boon or Bane for Health Care Providers?: Preface

Abstract

This From Research to Practice section focuses on polypharmacy, a term we do not often hear or read about in publications dealing with diabetes. Nonetheless, many of us routinely encounter the phenomenon of poly-pharmacy, or multiple medications, when dealing with patients. In general, the term "polypharma-cy" carries negative connotations, including increased costs, poorer compliance , and increased risk of side effects and drug interactions. Certainly all of these factors require careful consideration. Still, polyphar-macy may be a necessity to effectively manage diabetes and its associated complications and comorbidities. For example, a patient may require three oral medications to manage blood glucose, three medications for blood pressure control, and an additional two to three medications for lipid control. This would be a total of nine chronic medications not including aspirin or drugs for other diseases the patient may have. Some would argue that the goal should be to decrease the number of medications this patient requires. But while that course of action may be appropriate, I would counter that the primary goal should be to determine whether the medications are indicated for the disease state and whether they are safe and effective for the patient. It could be that this patient truly needs nine medications. With continued advances in pharmacological therapies, it is likely that the number of medications prescribed for our patients will continue to increase rather than decrease. The four articles included in this section provide us with a better understanding of polypharmacy as well as practical information about common drug-drug, over-the-counter (OTC) drug, and complementary therapy interactions seen in patients with diabetes.