Key points

Key points

  • Multimorbidity is associated with reduced quality of life, higher mortality, polypharmacy and high treatment burden, higher rates of adverse drug events, and much greater health services use (including unplanned or emergency care).

  • Polypharmacy in people with multimorbidity is often driven by the introduction of multiple medicines intended to prevent future morbidity and mortality in individual health conditions. The absolute benefit gained from each additional medicine is likely to reduce when people are taking multiple preventative medicines but the risk of harms increases. Resources and screening tools (see table¬†1) are available to help guide decision making about the appropriateness of prescribing and stopping medicines (deprescribing).

  • Options for local implementation:

    • Develop and agree an action plan for multimorbidity and polypharmacy to inform local medicines optimisation strategic and operational plans. Shared learning case studies are available showing how NICE guidance and standards have been put into practice by a range of NHS organisations.

    • Encourage and support a shared decision-making approach to care: see the related NICE key therapeutic topic on shared decision making that discusses this in more detail.

    • Develop an individualised, person-centred approach to reviewing the care and treatment of people with multimorbidity and polypharmacy, in line with the NICE guideline on multimorbidity. This may be included in local education and support initiatives to assist shared decision making in individualising care.