Clinical consequences of polypharmacy in elderly

Expert Opin Drug Saf. 2014 Jan;13(1):57-65. doi: 10.1517/14740338.2013.827660. Epub 2013 Sep 27.

Abstract

Introduction: Polypharmacy, defined as the use of multiple drugs or more than are medically necessary, is a growing concern for older adults. MEDLINE and EMBASE databases were searched from January 1, 1986 to June 30, 2013) to identify relevant articles in people aged > 65 years.

Areas covered: We present information about: i) prevalence of polypharmacy and unnecessary medication use; ii) negative consequences of polypharmacy; and iii) interventions to improve polypharmacy.

Expert opinion: International research shows that polypharmacy is common in older adults with the highest number of drugs taken by those residing in nursing homes. Nearly 50% of older adults take one or more medications that are not medically necessary. Research has clearly established a strong relationship between polypharmacy and negative clinical consequences. Moreover, well-designed interprofessional (often including clinical pharmacist) intervention studies that focus on enrolling high-risk older patients with polypharmacy have shown that they can be effective in reducing aspects of unnecessary prescribing with mixed results on distal health outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Age Factors
  • Aged
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Humans
  • Inappropriate Prescribing / adverse effects
  • Inappropriate Prescribing / prevention & control*
  • Interprofessional Relations
  • Nursing Homes / statistics & numerical data
  • Pharmacists / organization & administration
  • Polypharmacy*
  • Practice Patterns, Physicians' / standards*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Prevalence
  • Professional Role