Polypharmacy contributes to medication-related harm. Medication-related harm accounts for approximately 9% of hospital admissions worldwide, and it is estimated that many of these hospitalisations are preventable. It is therefore important to consider significant opportunities which can be used to reduce the burden of medication-related harm. These opportunities could involve the provision of timely and effective interventions, which include shared decision-making and a person-centred approach when undertaking reviews, where deprescribing may be an outcome as well as starting medications, to ensure optimised treatment. Strategies to avoid inappropriate polypharmacy, as a whole system and integrated approach by various members of the healthcare team, could also be considered as important interventions to reduce medication-related harm.

This chapter will discuss why polypharmacy is on the increase and why it is important to consider appropriate and inappropriate polypharmacy as well as the significance of deprescribing. It will describe why a person-centred prescribing and management of multimorbidity approach are important to consider during all stages of the medication management process.