Solving the challenges related to polypharmacy


Helsinki, Finland



Invested in:



Pauli Puirava, Sirkku Karinen, Panu Keski-Pukkila, Wintom Zecarias


Polypharmacy, IT

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Causalus’s mission is to become the world’s best polypharmacy related problem solver.

After spending almost 10 years performing medication reviews at elderly care homes as a consultant pharmacist, leading to a decrease of patient medication use, condition improvement and decreased costs - Pauli Puirava, Founder and CEO of Causalus, decided to turn his expertise into a scalable software solution. During his hands-on work at elderly care homes, Pauli felt the real human benefit and value in increasing the patients’ quality of life became a reality. This turned into a passion to build a team around the product, making the patient quality of life a mission.

There is no single definition of polypharmacy, although it is often defined as the use of five or more medicines on a daily basis. This may be any combination of prescription drugs, OTC medicines and dietary or herbal supplements. Sometimes the term is used to refer to the adverse effects from taking multiple medicines simultaneously, regardless of the number. In an analysis of a longitudinal, nationally representative study that the Pharmaceutical Journal conducted in 2015, found that 35.8% of adults in the United States were taking five or more medicines. Statistics are similar elsewhere – a 2014 analysis of Scotland’s electronic primary healthcare records showed that 16.9% of adults were receiving four to nine medications. That number rose to 28.6% for adults aged 60–69 years and to a significant number of 51.8% of the population aged over 80 years. Even if many drugs are safe when taken correctly, their associated risks can increase when combined with other treatments. The more drugs one takes, including a substance as innocuous as a vitamin, the higher the risks of a drug-to-drug interaction, an adverse drug event or non-adherence. Despite the large addressable issue, the available solutions in this field are very traditional. Typical solutions include pharmacists medication review and consultancy analysis services combined with doctors and nurses monitoring the health of patients. Interestingly there are very limited solutions that combine pharmacists expertise with up-to-date medication data and patient health/symptom tracking.

The Causalus solution was developed to fit into the nurses’ and doctors’ workflows, decreasing their mental load, visualizing drugs and symptoms and automatically alerting on adverse effects. Causalus- software, Pharmanalysis Oy is digitalising the specialist know-how required for medication reviews.The information that Causalus is able to show could take several hours of work for doctors to find in the currently used systems and would be impossible for the nurses to follow-up on. At the same time as nurses add information to Causalus, they are building up a unique set of adverse effect data that has been very difficult to create so far.