Family doctors in Catalonia have warned of an excess of medication among the population, especially in elderly people, and demand measures to reduce this phenomenon in primary care centers in neighborhoods and municipalities such as Girona, Barcelona and Tarragona.
Concern about polymedication in people over 65 years old
According to the Catalan Society of Family and Community Medicine (CAMFiC), polymedication affects between 40% and 50% of people over 65 years old. This term refers to the habitual intake of five or more medications. The situation is especially relevant in areas with an aging population, where one in five people over 75 years old continuously consumes ten or more drugs.
In Girona, the latest data from the Department of Health indicate that almost 30,000 people take ten or more prescribed medications or treatments for at least three months. This figure represents 3.1% of the total population of the demarcation.
Risk factors and territorial inequality
The group of people aged 60 or more, which represents approximately a quarter of the Catalan population, concentrates 69% of prescriptions and healthcare spending. Areas with a lower socioeconomic level show a greater exposure to polymedication, according to experts.
Laia Gené, member of the Elderly Group of CAMFiC, points out that in primary care it is common to find elderly people who consume a high number of medications, some without a clear benefit. Gené emphasizes that the goal is not to abandon treatments, but to optimize them.
"Demedicalize does not mean to abandon treatment, but to optimize it" - Laia Gené, CAMFiC
Deprescribing and challenges in primary care
Deprescribing consists of analyzing the drugs the patient takes and, if appropriate, reducing or withdrawing them in a consensual and safe manner. The objective is to improve quality of life and minimize unnecessary risks. Gené highlights that in situations of frailty or at the end of life, comfort should be prioritized over preventive treatments.
From CAMFiC, several obstacles are identified to advance in medication reduction. Some patients fear worsening if any drug is withdrawn from them or lack sufficient information about their treatments. On the part of professionals, there are time limitations, lack of specific training to withdraw medications, and fear of possible negative consequences.
"Deprescribing must be progressive and supervised, with constant reviews and, if it is not possible to eliminate a drug entirely, at least by adjusting the dose" - Laia Gené, CAMFiC
Proposals to improve safety and care continuity
The scientific society recommends strengthening interdisciplinary work among family doctors, nursing, and clinical pharmacy to increase safety and ensure better care continuity. They also consider it essential to involve patients and their families in decision-making, offer specific training to professionals, and have more time to review treatments and perform individualized follow-up.
Among the proposed strategies is the priority withdrawal of clearly unnecessary medications or those with a high risk, known as "quick wins".
The Elderly People group reminds that this process requires coordination, active listening and shared decisions, with the family doctor as a key figure and the support of nursing and pharmacy.
Periodically reviewing pharmacological treatments is a practice linked to care quality and patient safety. CAMFiC insists that medication reduction must be done progressively and always under professional supervision.