title: [Less can be more - drug therapy in the elderly].
abstract: A significant proportion of the elderly population is affected by multimorbidity and polypharmacy. Drug safety in this population is characterised by age-associated changes in pharmacokinetics and pharmacodynamics, an increased risk for drug-drug interactions, an unmanageable situation of side effects and co-morbidities, and a questionable adherence to complex therapies. Moreover, elderly multimorbid patients are usually not enrolled in clinical trials, and therefore the evidence for efficacy and safety of drugs is sparse. Many practice guidelines do not consider multimorbidity and age-associated changes in physical function, cognition and reduced life expectancy. Most published approaches to reducing polypharmacy such as algorithms and checklists have not yet been validated prospectively in randomised, controlled trials. However, some studies have shown the feasibility of stopping medications, in some cases accompanied by remarkable improvements of quality of life. (As supplied by publisher).
authors.affiliation: Lehrstuhl für Klinische Pharmakologie, Universität Witten/Herdecke, Philipp Klee-Institut für Klinische Pharmakologie, HELIOS Klinikum Wuppertal, Wuppertal. petra.thuermann@helios-kliniken.de
authors.forename: Petra A
authors.initials: PA
authors.lastname: Thürmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002908:Chronic Disease / Q000188:drug therapy*; D015897:Comorbidity; D004359:Drug Therapy, Combination / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D008017:Life Expectancy; D008297:Male; D055118:Medication Adherence; D017410:Practice Guidelines as Topic; D055553:Prescription Drugs / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D055553:Prescription Drugs