Polypharmacy in the elderly: maximizing benefit, minimizing harm.
The purpose of this article is to define our current understanding of appropriate prescribing and outline the potential hazards of overprescribing, while acknowledging the benefits of modern pharmacologic treatment. Finally, we discuss practical strategies to attempt to achieve optimal prescribing patterns for the elderly. Polypharmacy, as well as inappropriate prescribing, for the elderly is a major problem and a challenge that contributes to costs, adverse drug events, confusion, compliance issues, and errors in management. A systematic approach to drug monitoring is an important aspect of appropriate prescribing. Attention to prescribing of medications, consistent review of medication lists, and reevaluation of indications and outcomes of prescribing are essential to ensure that polypharmacy is minimized and safety for patients is maximized. This article acts as a practical review for caregivers in multiple practice situations including acute care hospitals, outpatient settings, long-term care, and home care.
Ballentine
Noel H
NH
Division of General Internal Medicine, Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA. nballentine@psu.edu
D000368:Aged; D004347:Drug Interactions; D016903:Drug Monitoring; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D015577:Geriatric Assessment; D019983:Guideline Adherence; D006301:Health Services Needs and Demand; D006801:Humans; D008508:Medication Errors / Q000379:methods / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D019338:Polypharmacy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D012307:Risk Factors; D017751:Safety Management / Q000458:organization & administration*