28 Apr Why medication management is getting harder in healthcare

Patient needs are getting more complex and that’s starting to show in how medications are prescribed and managed. Patients are living longer, often with more than one condition at the same time and treatment plans now involve several drugs rather than just one or two. That makes medication decisions harder to manage in practice, especially when different conditions are being treated at once. It also explains why more advanced pharmacy training, such as obtaining a doctor of pharmacy degree, is becoming relevant across different healthcare settings.

More patients are on multiple medications at the same time. Recent data suggests that around with that number rising in older age groups. Among adults over 60, roughly one in three are taking five or more medications on a regular basis.

This affects how treatment is handled day to day. Each additional drug increases the chance of interactions, side effects and changes in how other medications behave in the body. It also makes monitoring harder, particularly when care is spread across different providers. A patient might receive prescriptions from a general practitioner, a specialist and a hospital team and those decisions don’t always sit in one place.

Adherence is another issue. Dosing schedules don’t always align and some medications have specific requirements around food or timing. It doesn’t take much for something to go wrong. Missing doses, taking drugs too close together, or misunderstanding instructions can all affect how well a treatment works. In some cases, patients end up stopping medication altogether because the routine becomes too difficult to manage.

Medication decisions are not as straightforward anymore

As treatment becomes more complex, the role of pharmacists has shifted. It is no longer limited to dispensing medication. Pharmacists are now more involved in reviewing treatment plans, flagging potential risks and working with other clinicians when changes need to be made.

A lot of this comes down to detail. How drugs interact, whether dosages still make sense and how a patient is actually responding over time. Some issues are not obvious at first. Prescribing cascades are one example, where a side effect is treated with another medication instead of adjusting the original one. That can build up over time without being spotted straight away.

Medication reconciliation is another part of the job, especially during hospital admission or discharge. The aim is to keep medication lists accurate and consistent. It sounds straightforward, but mistakes here are common and can cause real problems, particularly when treatments are changed quickly or information is missing.

It doesn’t look the same everywhere. In some systems, pharmacists are part of the care team and involved in daily decisions. In others, the role is still more limited and developing.

The risk builds quickly as more drugs are added

The main issue with polypharmacy is how quickly risk increases. Research shows that the likelihood of adverse drug reactions rises sharply as more medications are introduced, reaching around 50% once a patient is taking five or more drugs.

Drug interactions are also common. When several medications are used together, interactions are often present and some of them are serious. These are not always picked up immediately. Sometimes they only become clear after a dose change or when a new drug is added.

Small changes can have wider effects than expected. A treatment aimed at one condition can affect something else, particularly in patients with more complex medical histories. Cardiovascular medications, for example, can influence kidney function, which then affects how other drugs are processed. Something similar can happen with medications that affect liver enzymes, which changes how quickly other drugs are broken down.

At that point, monitoring becomes more important. Without it, problems can build over time. Regular medication reviews help reduce unnecessary prescriptions and give clinicians a chance to step back and check whether each drug is still needed. These reviews are not always routine, but they are becoming more common as the risks become clearer.

Training is starting to shift to match this

As responsibilities change, training is shifting as well. Pharmacy roles now involve more independent decision-making and a stronger focus on applying clinical evidence in real situations. In some cases, that includes reviewing how care is delivered and identifying where treatment pathways can be improved.

This level of responsibility is typically supported by a doctor of pharmacy degree, which prepares pharmacists for clinical practice, patient care and decision-making roles. Training includes pharmacotherapy, patient assessment and evidence-based treatment, alongside time spent in clinical settings under supervision.

There is also more focus on working across teams. Pharmacists work alongside physicians, nurses and other healthcare professionals, contributing to shared decisions about patient care. That collaboration is becoming more common as treatment becomes more complex, particularly in hospital settings and specialist clinics.

Practical experience still matters just as much. Clinical placements, supervision and ongoing assessment are needed to make sure decisions in practice are safe. Expanding responsibilities without that would create different risks. Healthcare systems are still adjusting. In some areas, the benefits are clear. In others, the shift is slower. What is consistent is the level of complexity involved in managing medications and it doesn’t look like it’s easing any time soon.

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Last Updated on April 28, 2026 by Marie Benz MD FAAD