There are three primary considerations to recognizing polypharmacy: new medication, new side effect, and new symptom. When a resident starts a new medication, be sure to watch for things like:

• A change in participation in daily activities
• Falls
• A change in behavior (e.g. depression, anxiety, or delirium)
• Symptoms like nausea, headache, stomach pain, or rash

If nursing staff suspects polypharmacy, next steps include:

• Ask if a new medication was recently started.
• Develop a list of current medications found in bottles, lists, and pillboxes. Include over-the-counter medications and vitamins and supplements. Check for both the date of the last fill and the expiration date.
• Request an on-demand review of the resident’s medication regimen by the team pharmacist. The main purpose of a review is to improve the appropriateness of medications, reduce harm, and enhance outcomes.