Rajiv Bandaru


Concomitant use of multiple prescription drugs (‘polypharmacy’) is increasingly common, with 10% of the population and 30% of older adults in the United States taking five or more drugs simultaneously. Similarly, high prevalence is reported in other countries (e.g., the United Kingdom, Sweden, China, Brazil, and India. The prevalence of polypharmacy is driven by high rates of comorbidities (in the United States in 2012, 26% of all adults, and 61% of adults over 65 years of age had two or more chronic conditions) and exacerbated by clinical practices enabling over-prescription and insufficient monitoring. Drug-related morbidity has become a substantial healthcare burden: in the United States, adverse drug reactions are prevalent (causing 4 hospitalizations per 1000 people each year), serious (among top 10 common causes of death), and expensive (with associated annual costs estimated at US$30billion to US$180billion).


DMHEART, population, monitoring

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The NHS Health & Social Care Information Centre. Prescription Cost Analysis England 2015. Leeds: NHS Health And Social Care Information Centre, 2016.

The NHS Health & Social Care Information Centre. Prescription Cost Analysis - England 2011. Leeds: The NHS Health & Social Care Information Centre, 2012.

Rosso AL, Eaton CB, Wallace R, et al. Geriatric syndromes and incident disability in older women: results from the women’s health initiative observational study. J Am Geriatr Soc 2013;61:371–9.

Martin NJ, Stones MJ, Young JE, et al. Development of delirium: a prospective cohort study in a community hospital. Int Psychogeriatr 2000;12:117–27.

Salazar JA, Poon I, Nair M. Clinical consequences of polypharmacy in elderly: expect the unexpected, think the unthinkable. Expert Opin Drug Saf 2007;6:695–704.

Mallet L, Spinewine A, Huang A. Prescribing in elderly people 2 - the challenge of managing drug interactions in elderly people. Lancet 2007;370:185–91.

Age UK. Stop Falling: start saving lives and money. Age UK 2010.

Ziere G, Dieleman JP, Hofman A, et al. Polypharmacy and falls in the middle age and elderly population. Br J Clin Pharmacol 2006;61:218–23.

Kojima T, Akishita M, Nakamura T, et al. Association of polypharmacy with fall risk among geriatric outpatients. Geriatr Gerontol Int 2011;11:438–44.

Farmer C, Fenu E, O’Flynn N, et al. Clinical assessment and management of multimorbidity: summary of NICE guidance. BMJ 2016;354:i4843

Walckiers D, Van der Heyden J, Tafforeau J. Factors associated with excessive polypharmacy in older people. Arch Public Health 2015;73:50

Chew LD. The impact of low health literacy on diabetes outcomes. Diabetes Voice. 2004;49(3):30–32.

Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood) 2001;20(6):64–78.

McNabb WL. Adherence in diabetes: can we define it and can we measure it? Diabetes Care. 1997;20(2):215–218.

Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM. Self-management education for adults with type-2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care. 2002;25(7):1159–1171.

Walker E. Characteristics of the adult learner. Diabetes Educ. 1999;25(6 Suppl):16–24.

Goodall TA, Halford WK. Self-management of diabetes mellitus: a critical review. Health Psychol. 1991;10(1):1–8.

Toljamo M, Hentinen M. Adherence to self-care and glycemic control among people with insulin-dependent diabetes mellitus. J Adv Nurs. 2001;34(6):780–786.

Wing RR, Goldstein MG, Kelly JA, Birch LL, Jakic JM, Sallis JF. Behavioral science research in diabetes. Diabetes Care. 2001;24(1):117–123.

Grant RW, Devita NG, Singer DE, Meigs JB. Poly-pharmacy and medication adherence in patients with type 2 diabetes. Diabetes Care. 2003;26(5):1408–1412.

Anderson RM. Patient empowerment and the traditional medical model: a case of irreconcilable differences? Diabetes Care. 1995;18(3):412–415.


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