New tool: Polypharmacy load meter
We launched a 7-question tool that evaluates polypharmacy load in older adults and directs users toward a comprehensive medication review (LHKA, the Finnish pharmacist-led protocol) when needed. Based on Käypä hoito guidelines and the Finnish Fimea LHKA protocol.
In Finland, an estimated 45.5% of adults over 65 take five or more regular medications per day — the international threshold for polypharmacy. Many are on 10 or more. The issue is not just the count but the drug-drug interactions, duplicate therapy, and forgotten legacy prescriptions that accumulate over years from different doctors.
Today we launched the polypharmacy load meter at monidose.fi/en/polypharmacy-load — a 7-question tool that helps identify whether it is time to book a pharmacy-led medication review.
What it measures
Seven questions cover the main polypharmacy risk factors:
1. Daily medication count — 5+ meets polypharmacy criteria, 10+ is major polypharmacy 2. Number of prescribing doctors — multiple without coordination raises duplicate-therapy risk 3. Frequency of medication changes in the past 6 months 4. Dosing times per day — a complex schedule multiplies error risk 5. High-risk medication categories in use (anticoagulants, opioids, sleep aids, insulin) 6. Has a medication review (LHKA) been done? — the most effective single tool for managing polypharmacy 7. Experienced side effects — the first signal the regimen may be out of balance
What the tool produces
Load score 0–29 plus a visual gauge
Tier (Low / Moderate / Polypharmacy / Critical)
Concrete action recommendations for each tier
Direct pointer to LHKA when polypharmacy thresholds are reached
Why LHKA matters
The Finnish medication review (LHKA) is a pharmacist-led or physician-led comprehensive review of all medications in use. Defined by the Fimea protocol. It is the most effective single way to identify:
Drug-drug interactions (e.g. anticoagulants + certain painkillers)
Duplicate therapy (same active substance prescribed by different doctors)
Legacy medications that are no longer needed (started years ago, never stopped)
Dose errors relative to declining kidney function in older adults
If the load assessment returns "Polypharmacy" or "Critical load", the tool points the user to book an LHKA before any medication changes are made.
What the tool does NOT do
We deliberately kept the tool tightly scoped for liability reasons:
Does not flag specific drug interactions — no "Warfarin + ibuprofen = risk" style alerts. Those conversations happen at the pharmacy during LHKA.
Does not suggest medication changes — every action recommendation points to "discuss with pharmacist/doctor".
Does not store answers — everything runs in your browser.
Who it's for
Family members tracking an ageing parent's growing medication list
Home-care professionals who want a fast load assessment before formal review
Patients themselves wondering whether the balance of their medications is sensible
Sources
Käypä hoito — Medication in the elderly
Fimea — Medication review (LHKA) protocol
Fimea — High-risk medications in older adults
interRAI Home Care — Medications (Section M)
WHO — Adherence to Long-Term Therapies (2003)
Try it
The tool is available at monidose.fi/en/polypharmacy-load. Takes under 5 minutes, no registration.
MoniDose is under development as a Class I medical device under EU MDR 2017/745. This tool is an indicative assessment and does not replace a pharmacist-led medication review (LHKA) or physician guidance. Do not make medication changes without expert instruction.