title: Pharmacotherapy at the end-of-life.
abstract: Older people reaching end-of-life status are particularly at risk from inter-related adverse effects of pharmacotherapy, including polypharmacy, inappropriate medications and adverse drug events. These adverse effects of pharmacotherapy may be highly detrimental, as well as highly expensive. End-of-life pharmacotherapy is sometimes perceived to be complex and challenging, probably unnecessarily. This relates in part to the poorly developed evidence base and lack of high-quality research in this area. In this article, we deal with some of the key issues relating to pharmacotherapy in end-of-life patients, namely (i) the guiding principles of drug selection, (ii) the main drugs and drug classes that are best avoided, (iii) the benefits of 'oligopharmacy' (i.e. deliberate avoidance of polypharmacy) in end-of-life patients.
authors.affiliation: Department of Medicine, University College Cork, University Hospital, Wilton, Ireland. denis.omahony@hse.ie
authors.forename: Denis
authors.initials: D
authors.lastname: O'Mahony
authors.forename: Marie N
authors.initials: MN
authors.lastname: O'Connor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000075202:Contraindications; D004358:Drug Therapy; D064420:Drug-Related Side Effects and Adverse Reactions; D019317:Evidence-Based Medicine; D016330:Frail Elderly; D006801:Humans; D057970:Inappropriate Prescribing / Q000009:adverse effects*; D008017:Life Expectancy; D010166:Palliative Care; D018579:Patient Selection; D019338:Polypharmacy; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D055502:Secondary Prevention