7.

POLIFARMASI

Apt. Nur Atikah, M.Sc.

Jurusan Farmasi
Poltekkes Kemenkes Surakarta
 Agenda
01 Pendahuluan Polifarmasi
Plan Pengertian polifarmasi, dampak ekonomi polifarmasi, faktor
yang mempengaruhi polifarmasi

02 Medication Review pada Polifarmasi

03 Pendekatan sistem kesehatan pada polifarmasi

Pengertian Poli-
farmasi

Polypharmacy is the concurrent use

of multiple medications. Although
there is no standard definition,
polypharmacy is often defined as the
routine use of five or more
medications. This includes over-the-
counter, prescription and/or
traditional and complementary
medicines used by a patient
 GOAL
reduce inappropriate
polypharmacy (irrational
prescribing of too many
medicines) 01

ensure appropriate
polypharmacy (rational
prescribing of multiple
medicines based on best
available evidence and
02
considering individual
patient factors and
context)
 Appropriate polypharmacy

A. B.

all medicines are prescribed for therapeutic objectives are

the purpose of achieving actually being achieved or there
specific therapeutic objectives is a reasonable chance they will
that have been agreed with the be achieved in the future
patient;

C. D.

medication therapy has the patient is motivated and

been optimized to minimize able to take all medicines
the risk of adverse drug as intended
reactions (ADRs);
 Appropriate Polypharmacy

Appropriate polypharmacy recognizes that patients can benefit

from multiple medications if the patients’ clinical conditions,
comorbidities, allergy profiles, the potential drug–drug and drug–
disease interactions are considered, and the medicines are
prescribed based on the best available evidence
harmacy

Thus, it is critical to distinguish appropriate polypharmacy from

inappropriate polypharmacy
drug–drug interactions,
higher risk
of falls, ADRs,
cognitive impairment,
non-adherence and
poor nutritional status

Resiko polifar-
masi
Dampak ekonomi
polifarmasi

Mismanaged polypharmacy contributed

to 4% of the world’s total avoidable costs
due to suboptimal medicine use.
A total of US$ 18 billion, 0.3% of the
global total health expenditure could be
avoided by appropriate polypharmacy
management
 Faktor yang mempengaruhi polifarmasi
Social determinants of
health and lifestyles
income, work and social
protection.
unhealthy lifestyle can
contribute to multimorbidity
Individuals with low incomes
may be restricted in their
choice of healthy ageing
options as healthy foods,
health care and housing may
be less affordable and
accessible, and are thus
at higher risk of ill health and
disability
Non-adherence
This is major challenge in
polypharmacy, particularly
among older persons and/or
in patients with multimorbidity
Content Title
Here A systematic review of older
patients with polypharmacy found
a correlation between medication
non-adherence and the number
of medicines being taken
Area tempat terjadi polifarmasi
Polypharmacy at
transitions of care 
Penting rekonsiliasi
Polypharmacy in care homes.
the average care home resident in England was
taking eight medications a day and
over two thirds of these residents had one
or more medication errors

Traditional and complementary

Non-prescribed medicines
medications Health care providers should
many patients self- ask their patients if they use traditional
medicate by purchasing and complementary medicines or
OTC medicines remedies
Medication Re-
view in
Polypharmacy
Medication review is a
structured evaluation of
patient’s medicines with
the aim of optimizing
medicines use and improving
health outcomes. This entails
detecting drug related
problems and recommending
interventions
Step by step approach to conducting a patient centred medica-
tion review
Step by step approach to conducting a patient centred medica-
tion review
 Deprescribing is the
process of tapering,
stopping, discontinuing, or
withdrawing drugs, with the
goal of managing
polypharmacy and
improving outcomes
Health system approach to polypharmacy

er ing
deliv
nt s in acy
i e
o f pat ypharm nals
role ate po
l i o
Th e r i rofe s s
prop re p
p ca
01
a h
lt
Hea
02
es of
i ne ctic
i c pra
Med and
03 Sy s
s
tem ion
icat
04 m e d
1. Residents in a care home setting
2. Patients on high-risk (high-alert)
medications
3. Patients taking 10 or more Prioritizing patients for
medicines medication reviews in
4. Patients with two or more co- polypharmacy
morbidities
5. Patients with frailty
6. Patients with dementia
7. Palliative care situations
Key Steps for Ensuring Medication Safety
Thank You