Dr Sanket Raut MBBS PhD
Research Fellow, Veteran Health, Gallipoli Medical Research 

In my research, I spend a lot of time looking at medicines, how they are used, how they interact, and most importantly, how they affect people’s lives. One issue that keeps coming up, especially among veterans, is something called polypharmacy. It’s a clinical term, but the idea is simple: it means taking multiple medications at the same time.

For many people, this might sound normal. After all, if you have more than one health condition, you might need more than one medicine. But polypharmacy becomes a problem when the number of medications grows to a point where the risks start to outweigh the benefits.

Veterans are particularly affected by this.

Through my work analysing health data from veteran populations, I’ve seen that many individuals are prescribed medicines for both physical and mental health conditions, often at the same time. Conditions like chronic pain, post-traumatic stress disorder (PTSD), anxiety, depression, and sleep disturbances frequently occur together, and each may be treated with one or more medications. In one of our research projects, I saw veterans taking more than 10 different medications to manage these overlapping conditions. Individually, each prescription made sense. But together, they created a complicated mix that increased the risk of side effects, drug interactions, and even reduced effectiveness. This is the hidden challenge of polypharmacy—it often develops gradually and quietly.

Why does this happen more in veterans?

Part of the answer lies in the nature of military service. Veterans are more likely to experience both physical injuries and mental health challenges as a result of their service. These conditions are often long-term and interconnected. For example, chronic pain can worsen mental health, while PTSD can disrupt sleep and increase reliance on medications.

Another factor is the way healthcare is delivered. Veterans may see multiple healthcare providers including GPs and specialists each focusing on a specific issue. While this care is well-intentioned, it can sometimes lead to fragmented treatment, where medications are added without a full picture of what the person is already taking. There’s also a cultural element. Many veterans are trained to push through pain and not question authority. This can make it harder for them to raise concerns about their medications or ask whether all of them are still necessary.

This is why my work focuses not just on identifying polypharmacy, but on improving how we manage it. We are currently developing a decision support tool to help clinicians make safer, more informed prescribing decisions, especially in complex cases where multiple medications are involved. Alongside this, we are working to improve health literacy, helping veterans understand their medications, feel confident asking questions, and be active participants in their care. We are also exploring digital tools, including a mobile app, to support both veterans and clinicians in navigating these decisions together.

Polypharmacy isn’t just about numbers, it’s about people. It’s about ensuring the treatments meant to help don’t end up causing harm. If we can better understand why polypharmacy happens, especially in vulnerable groups like veterans, we can start to reduce its risks and improve quality of life. And that’s ultimately what this work is about.