Multimorbidity

People are living longer and are suffering from multiple illnesses. It would be useful to carry a diary that shows recent blood pressure monitoring results, HbA1c, glucose levels, cholesterol readings, thyroid levels and any other tests performed . Most research and guidelines deal with ideas for single diseases whereas in real life most of our patients have multimorbidity and drug interactions. This raises many questions. Does the research apply to them, how do we avoid potentially harmful polypharmacy? How do we best help these patients?

In my 30’s when I first became interested in polypharmacy, working with my fabulous Doctors in Murton, Seaham, Co Durham, UK. As a pharmacist, I raised concern that some of the older patients had too many drugs, too much polypharmacy and I was concerned about the interactions. The doctors very kindly asked me to accompany them on their rounds for a couple of weeks so that I could see the problems they were facing day to day. This was a major turning point in my life when I saw first hand the changes in the human body as it becomes old and ill and I realised how important the polypharmacy is toward the end of life. It is the difference between a peaceful pain free death, trying to treat each symptom as it arises. The other option is a difficult, hellish experience that tortures patients and leaves friends and family traumatised. It is my qualified opinion from 34 years of frontline experience that polypharmacy is essential for elderly, terminally ill and patients with multimorbidity.