As a person is diagnosed with more conditions and medical problems, multiple medications are often required to manage those health issues. The use of multiple prescriptions, over-the-counter medications, and supplements and vitamins is known as polypharmacy. And, instead of helping a person, it can actually diminish overall wellness.

The University of Louisville has long tackled this issue through the Frazier Polypharmacy Program, led by Demetra Antimisiaris, PharmD, CGP, FASCP.

The program, dedicated to research, education and outreach, continues to grow as Antimisiaris broadens the focus of her study beyond the geriatric population.

“Historically, polypharmacy was exclusively a problem of aging, but now it is a part of life for all ages, including middle-aged adults and children. If a child has asthma, diabetes and ADHD, they could be receiving as many as seven or more medications, not including over-the-counter medication,” said Antimisiaris, who recently joined the UofL School of Public Health and Information Sciences Department of Health Management and Systems Sciences.

She points out that although science indicates that the use of five medications at the same time increases the odds of adverse events for older adults, it would take double that to produce similar adverse events for middle-aged adults. Still, there are considerations of polypharmacy exposure in younger people that may differ from the traditional concerns in older adults.

“We don’t fully understand the effect of medication burden on learning, cognition, mood or physical function – or even what long-term medication use may mean for a younger person’s physical or mental wellness into adulthood,” Antimisiaris said.

Antimisiaris also serves as assistant dean for Continuing Education and Professional Development and has a part-time appointment in the UofL School of Medicine’s Department of Neurology. One of the most significant contributions of the Frazier Polypharmacy Program to date has been creation of continuing education programs on polypharmacy.

Her research interests center on multi-stakeholder decision-making on medication use. Antimisiaris says polypharmacy can’t be studied as a science in the absence of understanding the human factors influencing medication use, and she focuses her studies on the interface of science with how people use information and understand medications.

Receiving a High Honor 

The American Society of Consultant Pharmacists (ASCP) has recognized Antimisiaris’ contributions to the profession, and will confer her with the George F. Archambault Award, the organization’s highest honor during its annual meeting Nov. 7 in Texas.

 “Dr. Antimisiaris’ entrepreneurial initiative, incredibly strong work ethic and talent as an excellent communicator and teacher have led her to prominence in both her chosen disciplines of clinical pharmacy, pharmacology and therapeutics, and in many other diverse circles,” said Chris Alderman, B Pharm, PhD, FSHP, BCPP, CGP, associate professor, Pharmacy Practice, University of South Australia, who nominated her for the award. “Earlier in her career, she led a novel academic initiative and authored new content addressing the issue of polypharmacy for nurses, physicians, pharmacists, social workers, basic scientists, therapists and even those outside of health care. At the time, there was little information on polypharmacy available, and Dr. Antimisiaris was forging a path in what has now come to be recognized as an area critical to the safe and effective use of medicines.”

ASCP Archambault Award honorees are selected by past recipients and based on their significant contributions to consultant or senior care pharmacy. Past recipients include Mark Beers, MD, who developed the Beers Criteria, evidence-based recommendations tailored specifically for older adults, and Jerry Gurwitz, MD, whose canonical work shed light on the significance of preventable medication problems.

“We are extremely thrilled that Dr. Antimisiaris has received such recognition for her innovative work including her success in the creation of online technologies and other novel approaches to reduce the risk arising from polypharmacy for vulnerable populations,” said Christopher E. Johnson, chair, Department of Health Management and System Sciences, UofL School of Public Health and Information Sciences. “As a mentor and teacher, she has led many students on scholarly projects and continues to make a lasting impact on future, as well as current health care practitioners.”