One size fits all? How to optimize the prescribing of appropriate polypharmacy in chronic diseases, using a behavioral approach - a United Kingdom perspective

The use of medicines is the mainstay of chronic disease management. However, chronic disease management has now evolved into the management of more than one disease for many patients, which in turn, has led to the use of multiple medicines (sometime described as polypharmacy) to manage these chronic diseases. The concept of polypharmacy has also undergone an evolution in terms of definition (many of which have relied on numerical thresholds) and value judgments (should polypharmacy be considered negative or positive in terms of treatment). This editorial will explore these issues, and consider how polypharmacy can be optimized at a population and patient level, with a focus on behavior change as a means to achieve appropriate polypharmacy.