Polypharmacy: prevention and management

We thank Tracy and colleagues for their supportive letter¹ in response to our series of case-based practice articles on polypharmacy.^2,3 Their letter accentuates the challenges of complex, ever-changing medication regimens, numerous comorbidities, multiple prescribers and time constraints in the effort to effect positive medication change. We applaud Tracy and colleagues for their initiative.

We agree that more tools are needed to support primary care physicians in their work with seniors. Not all physicians have access to a specialized interdisciplinary team, nor are they able to afford a significant block of time to address all the issues at hand. We hope that our case series (a total of eight case reports and two commentaries in Canadian Family Physician and the Canadian Pharmacists Journal)^4–11 will help physicians to prioritize medication changes and to realize that these changes do not need to happen all at once. In emphasizing the supporting roles of the various health professionals on our team, we hope to assist primary care physicians to determine whether some functions could be carried out by existing team members. Physicians should also be aware of local community supports, such as physiotherapy clinics with fall-prevention programs, when access to a specialized geriatric team is not available. We recognize that this is a work in progress.