Excessive polypharmacy and complex medication regimens are associated with greater physician burden in home healthcare

Tsukuba, Japan—Patients receiving home-based medical care are often older adults with multiple chronic conditions, and polypharmacy, commonly defined as the concurrent use of multiple medications, is prevalent in this population. However, the challenges of medication management extend beyond the number of prescribed medications. Factors such as dosing frequency, dosage forms, and special administration requirements can make medication regimens more difficult to manage for both patients and healthcare professionals. Although polypharmacy and complex medication regimens have been associated with increased treatment burden and medication-related problems, their relationship with the perceived clinical burden of physicians providing home healthcare has remained unclear.

To address this knowledge gap, researchers examined 503 patients receiving home-based medical care at seven medical institutions in Tokyo and Ibaraki Prefecture, Japan. The research team assessed both the number of prescribed medications and the complexity of medication regimens and investigated their associations with physicians' perceived clinical burden. The results showed that physicians experienced a significantly greater burden when caring for patients with excessive polypharmacy, defined as the use of 10 or more medications, and those with particularly complex medication regimens. These associations remained significant after adjustment for factors including patient age, comorbidities, and consultation time.

The findings suggest that improving medication management in home healthcare requires attention not only to reducing unnecessary medications but also to simplifying medication regimens whenever clinically appropriate. The researchers also highlighted the potential benefits of multidisciplinary collaboration, particularly between physicians and pharmacists, in optimizing pharmacotherapy, reducing physician burden, and ensuring safe and effective treatment for patients receiving home-based care. As healthcare systems continue to expand community- and home-based services to meet the needs of aging populations, strategies that support both patients and healthcare professionals will become increasingly important.

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This work was supported by the Japan Society for the Promotion of Science, 21K15658.

_{Original Paper}

Title of original paper:
Excessive Polypharmacy and Complicated Medication Regimen are associated with Physicians' Perceived Burden in Home Healthcare: A Multicenter Cross-Sectional Study

Journal:
Family Practice

DOI:
10.1093/fampra/cmag079

_{Correspondence}

Assistant Professor MASUMOTO, Shoichi
Institute of Medicine, University of Tsukuba

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Institute of Medicine