Polypharmacy in the elderly: a literature review.
OBJECTIVE
To review the body of literature addressing polypharmacy in individuals aged 60 years and older to (a) determine primary care providers' definition of polypharmacy, (b) explore how polypharmacy was assessed in primary care, and (c) seek tested interventions that address polypharmacy.


METHODS
A systematic review of electronic bibliographic databases (e.g. EBSCOHost, InfoTrac, OVID, FirstSearch, and FirstSearch Deluxe) utilizing the search terms "polypharmacy," "polypharmacy and elderly," "polypharmacy and research," and "multiple medications" for the period January 1991 to October 2003 was completed. The search was supplemented with online site searches of relevant journals and review of reference lists of each article.


CONCLUSIONS
Results of the literature review revealed that polypharmacy continues to be a significant issue and little research has been conducted regarding the methods primary care providers utilize to assess polypharmacy. Also, there is a gap in the literature regarding the interventions implemented by primary care providers to address polypharmacy.


CONCLUSIONS
The following definition of polypharmacy in clinical practice might be more practical: the use of medications that are not clinically indicated. Selecting appropriate limits for numbers of medications may be counterproductive in populations with multiple comorbidities.
Fulton
Maryann M
MM
Allen
Elizabeth Riley
ER
D000368:Aged / Q000502:physiology / Q000523:psychology / Q000706:statistics & numerical data; D000375:Aging / Q000187:drug effects / Q000378:metabolism / Q000523:psychology; D001291:Attitude of Health Personnel; D004347:Drug Interactions; D016903:Drug Monitoring / Q000379:methods; D004363:Drug Utilization / Q000706:statistics & numerical data; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D018579:Patient Selection; D010599:Pharmacokinetics; D010600:Pharmacology; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States