What criteria should I use to identify patients at risk of polypharmacy in my practice?

Criteria to identify patients at risk of polypharmacy in your practice include:

• Adults prescribed 15 or more regular medicines, as they are at higher risk of adverse events and drug interactions.
• Adults prescribed 10 to 14 regular medicines, who should also be considered at risk.
• Adults prescribed fewer than 10 regular medicines but who have particular risk factors for adverse events.
• Patients with multimorbidity, defined as having two or more long-term health conditions, including physical, mental health conditions, or symptom complexes such as frailty or chronic pain.
• Older adults or those with frailty, assessed by informal or formal tools such as gait speed, PRISMA-7 questionnaire, or self-reported health status, as frailty increases vulnerability to medication-related harm.

Using these criteria helps target structured medication reviews to optimise treatment, reduce treatment burden, and minimise medication-related problems.

References: NICE NG56, NICE NG5