title: Pharmacotherapy in the ageing patient: The impact of age per se (A review).
abstract: A literature search was carried out to review the influence of 'ageing' on pharmacotherapeutic decision-making, specifically how 'age' is defined and considered in the utilisation of medication. Embase, Medline, International Pharmaceutical Abstracts, and Google scholar were canvassed in a three-tiered search according to pre-established inclusion criteria. In tier 1, a total of 22 studies were identified highlighting the underutilisation of medication in elderly patients, with a particular focus on warfarin. Four studies highlighted an age-bias in medication-prescribing for elderly patients, specifically in relation to medicines for rheumatoid arthritis, angina, and hypertension. Tier 2 identified diverse definitions for 'elderly', including biological age, chronological age, physiological age, as well as various descriptions of 'elderly' in clinical trials and guidelines. Finally, medication optimisation tools were identified through the third tier, emphasising the use of chronological age to describe the 'elderly'. Old age influences pharmacotherapeutic decision-making at various levels, however, what complicates the situation is the absence of a comprehensive definition of 'elderly'. Clinical recommendations need to be based more on objective factors known to affect medication effectiveness and safety.
authors.affiliation: Graduate School of Health, School of Pharmacy, University of Technology Sydney, NSW 2007, Australia. Electronic address: shamshersingh@student.uts.edu.au.
authors.forename: Shamsher
authors.initials: S
authors.lastname: Singh
authors.affiliation: Graduate School of Health, School of Pharmacy, University of Technology Sydney, NSW 2007, Australia. Electronic address: Beata.Bajorek@uts.edu.au.
authors.forename: Beata
authors.initials: B
authors.lastname: Bajorek
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D000066491:Clinical Decision-Making; D004358:Drug Therapy / Q000379:methods*; D006801:Humans; D018579:Patient Selection
keywords: Age-bias; Definition; Elderly; Medication optimization