Clinical consequences of polypharmacy in elderly.
BACKGROUND
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.


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


CONCLUSIONS
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.
Duquesne University, Pharmacy , 321 Bayer Building, 600 Forbes Avenue, Pittsburgh, PA 15209 , USA maher@duq.edu.
Robert L
RL
Maher
Joseph
J
Hanlon
Emily R
ER
Hajjar
D000367:Age Factors; D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D006801:Humans; D057970:Inappropriate Prescribing / Q000009:adverse effects / Q000517:prevention & control*; D007400:Interprofessional Relations; D009735:Nursing Homes / Q000706:statistics & numerical data; D010595:Pharmacists / Q000458:organization & administration; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D015995:Prevalence; D024382:Professional Role