Polypharmacy describes the concomitant use of multiple medicines and represents a growing global challenge attributable to aging populations with an increasing prevalence of multimorbidity. Polypharmacy can be appropriate but is problematic when the increased risk of harm from interactions between drugs or between drugs and diseases or the burden of administering and monitoring medicines outweighs plausible benefits. Polypharmacy has a substantial economic impact in service demand and hospitalization as well as a detrimental impact on patients' quality of life. Apart from causing avoidable harm, polypharmacy can also lead to therapeutic failure, with up to 50% of patients who take four or more medications not taking them as prescribed. Guidance is needed to support patients and clinicians in defining and achieving realistic goals of drug treatment, and system change is necessary to aid implementation. This article outlines lessons from two programs that aim to address these challenges: the Scottish polypharmacy guidance on realistic prescribing and the European Union SIMPATHY project.

中文翻译：

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应对多元药学的挑战。

多元药房描述了多种药物的并用，并代表了日益增长的全球挑战，这归因于人口老龄化和多发病率的增加。当药物之间或药物与疾病之间相互作用或药物管理和监测的负担所造成的危害增加的风险超过了合理的收益时，多元药学可能是适当的，但存在问题。多元药房在服务需求和住院方面具有重大的经济影响，并且对患者的生活质量有不利影响。除了造成可避免的伤害外，多药治疗还可能导致治疗失败，多达50％服用四种或更多药物的患者未按规定服用。需要指导以支持患者和临床医生定义和实现药物治疗的现实目标，并且必须进行系统更改以帮助实施。本文概述了旨在应对这些挑战的两个计划的经验教训：有关现实处方的苏格兰多元药业指南和欧盟SIMPATHY项目。