Abstract

Multimorbidity often implies polypharmacy in chronic and complex patients, who have multifaceted care needs and require integrated and collaborative care from healthcare professionals and families. The doctor-patient relationship can have a therapeutic effect in itself. However, any drug prescription modifies the doctor-patient relationship. Polypharmacy distorts the doctor-patient relationship, transforming it into a “drug-patient relationship.” Understanding the psychosocial effects of prescribing on the doctor-patient relationship is as important, if not more so, than understanding pharmacology. The act of prescribing is always charged with human and magical resonances. The patient’s relationship with their favorite medications is much stronger than their relationship with any other person, including their doctor and pharmacist. Caring for complex patients with polypharmacy involves creating a different doctor-patient relationship and avoiding polypharmacy. People living with polypharmacy and complex chronic conditions need care from primary care physicians who avoid the “drug-patient relationship” as a substitute for the doctor-patient relationship and, in this context, recognize and address their multimorbidity as an integral disease that is constantly embedded in the life and context of a whole person. A priority for future research should be the development of new models of care that better serve these patients with polypharmacy.

Keywords: Polypharmacy; Multimorbidity; Physician-patient relations; General practice