Alternative Terms for Polypharmacy
The most commonly used alternative terms for polypharmacy include "multiple medication use," "hyperpharmacotherapy," and "extraordinary prescribing," though the field increasingly distinguishes between "appropriate polypharmacy" and "problematic polypharmacy" rather than using different terminology 1, 2.
Terminology Evolution
The term "polypharmacy" itself is acknowledged as "vague and imprecise" in current medical literature 1. This has led to several proposed alternatives:
Established Alternative Terms
- Multiple medication use - A more neutral descriptor that avoids the negative connotation of "polypharmacy" 2
- Hyperpharmacotherapy - Specifically refers to excessive medication use that may be inappropriate 2
- Extraordinary prescribing - A newer proposed term defining patients taking medications that are either grossly excessive or not beneficial, regardless of the actual number of medications 3
Qualitative Distinctions
Rather than replacing the term entirely, contemporary guidelines emphasize qualitative categorization 4:
- Appropriate polypharmacy - Prescribing for complex or multiple conditions where medicines use has been optimized and prescribed according to best evidence 4
- Problematic polypharmacy - Prescribing multiple medicines inappropriately, or where the intended benefit is not realized 4
Clinical Context
The push for alternative terminology stems from recognition that simply counting medications (the traditional definition of ≥5 medications) lacks clinical utility, particularly for older adults with multiple chronic diseases requiring evidence-based treatment 1. The number itself doesn't determine whether a patient will experience adverse events - the appropriateness of each medication matters more 3, 5.
Some researchers have even proposed redefining polypharmacy entirely as "patients going to more than one pharmacy for their prescriptions" to focus on fragmentation of care rather than medication count 3.