Intro

Polypharmacy is an ongoing issue in primary care that can lead to risks including adverse drug reactions, medication nonadherence and increased healthcare utilization. Clinical tools such as Beers and STOPP/START criteria help physicians identify inappropriate medications and opportunities for deprescribing. This study aims to assess knowledge, barriers and strategies to improve polypharmacy management among family medicine residents and physicians.

Method

A cross-sectional anonymous survey was conducted at Jackson Park Hospital including 18 residents and 6 attending physicians. Descriptive statistics and open ended responses were used to collect data. Study is IRB approved.

Results 

~75% reported familiarity with deprescribing tools and defined polypharmacy as the use of 5 or more medications. Nearly all agreed that it is an important clinical issue and that proper management improves patient safety. 

54% reported feeling inadequately trained to manage polypharmacy. While most stated that they routinely review medication lists, fewer consistently evaluate medications for potential deprescribing. Involvement of multiple prescribers is the biggest barrier (100%), followed by poor communication between providers (92%), limited consultation time (83%), and patient resistance to medication changes (79%).

To overcome these barriers, 83% suggested multidisciplinary team discussions, and 67% suggested spending more time with patients. EMR support tools were also identified as strategies for improvement.

 Discussion

Polypharmacy is an important issue. Key barriers include multiple prescribers, poor communication between providers, limited consultation time, and patient resistance to medication changes. Suggestions for improvement include better multidisciplinary collaborations and communication and decision supported tools within the EMR.

Conclusion

Polypharmacy is recognized as an important clinical issue, but physicians face several barriers in managing it effectively. Improving training, communication among providers, enhancing EMR tool support, collaboration with multidisciplinary teams may help support better medication management and enhance patient safety.