Multimorbidity and polypharmacy


Multimorbidity – usually defined as the presence of more than one long-term disorder within an individual – is becoming the norm rather than the exception as populations age. It has been shown that the majority of people aged 65 years or over are multimorbid, with number of comorbidities rising with increasing age, although multimorbidity is not confined to the elderly. Multimorbidity is associated with a range of adverse outcomes, including impaired physical, social, and psychological quality of life, and increased health service utilisation and mortality.

Health services are largely organised to provide care for single diseases. Researchers in CCHSR are trying to better understand how multimorbidity affects individuals and impacts on health services. We have examined issues such as quality of care, patient experience, quality of life and service use, and have explored the impact of factors such as socioeconomic deprivation and mental health.


One particular consequence of multimorbidity is polypharmacy – the prescribing on multiple medications to one individual. Polypharmacy is often appropriate, such as the routine use of multiple medications in the management of many cardiovascular diseases and related risk factors such as diabetes or hypertension. However, it can also be inappropriate, such as where the intended benefit is not realised, harm outweighs benefit, undesirable prescribing cascades result, or the treatment burden for patients is unacceptable. Measuring and understanding the extent of inappropriate polypharmacy, the factors influencing it, and the adverse consequences, are subject to ongoing study within CCHSR.

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