Polypharmacy in Older Adults
Polypharmacy, associated with adverse health outcomes, is common in older adults owing to increasing chronic conditions. In addition to normal organ system changes that affect pharmacokinetic, and pharmacodynamics of medications, drug-drug interaction and drug-disease interactions should be reviewed. Tools to minimize polypharmacy should be considered when treating older adults. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 7, 2022 Category: Geriatrics Authors: Wynnelena C. Canio Source Type: research
Polypharmacy in the Hospitalized Older Adult
This article reviews polypharmacy in the hospitalized older adult from their admission to hospitalization and transition of care as well as highlighting principles to reduce polypharmacy and tools for deprescribing during hospitalization. We review common reasons for admission and how these conditions may be particularly affected by or contribute to polypharmacy in older adults. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 7, 2022 Category: Geriatrics Authors: Analiese DiConti-Gibbs, Kimberly Y Chen, Charles Edward Coffey Source Type: research
Polypharmacy
CLINICS IN GERIATRIC MEDICINE (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 7, 2022 Category: Geriatrics Authors: EDWARD SCHNEIDER, BRANDON K. KORETZ Source Type: research
Copyright
ELSEVIER (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 7, 2022 Category: Geriatrics Source Type: research
Contributors
EDWARD SCHNEIDER, MD (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 7, 2022 Category: Geriatrics Source Type: research
Contents
Edward Schneider and Brandon K. Koretz (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 7, 2022 Category: Geriatrics Source Type: research
Forthcoming Issues
Practical Aspects of Cognitive Impairment and the Dementias (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - October 7, 2022 Category: Geriatrics Source Type: research
Polypharmacy in the Homebound Population
The number of homebound elders has risen dramatically in the past decade and was accelerated by the Sars-Cov-2 COVID-19 pandemic. These individuals generally have 5 or more chronic conditions, take 6 or more medications, and are at elevated risk for functional decline. Polypharmacy constitutes a major burden for these individuals, putting them at risk for medication nonadherence, medication errors, medication interactions, and reduced quality of life. A team-based approach may help these elders manage medications more effectively. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - September 13, 2022 Category: Geriatrics Authors: Erin Atkinson Cook, Maria Duenas, Patricia Harris Source Type: research
Polypharmacy in Hospice and Palliative Care
This article discusses common medications that can be deprescribed in the palliative/hospice patients and provides toolkits for future reference. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - September 13, 2022 Category: Geriatrics Authors: Angela Yeh, Amy Z. Sun, Helen Chernicoff Source Type: research
Polypharmacy in Oncology
Polypharmacy, defined as taking five medications or more, is a common geriatric syndrome. It is especially prevalent in older adults with cancer. For older patients with breast, lung, prostate, and colorectal cancer and chronic lymphocytic leukemia, polypharmacy has numerous adverse effects, including interactions with medications prescribed for other comorbidities. Polypharmacy is influenced by drug –drug interactions and can reduce the efficacy of systemic cancer therapeutics. It is also associated with worse progression-free and overall survival for some cancers such as lung and colorectal cancer. This highlights the ...
Source: Clinics in Geriatric Medicine - September 13, 2022 Category: Geriatrics Authors: Justin J. Cheng, Asal M. Azizoddin, Michael J. Maranzano, Narine Sargsyan, John Shen Source Type: research
Polypharmacy in Osteoporosis Treatment
In older adults, polypharmacy and osteoporosis frequently occur contemporaneously. Polypharmacy is increasingly recognized as a risk factor for hip and fall-related fractures. Treatments for osteoporosis include antiresorptive (alendronate, risedronate, zoledronic acid, ibandronate, denosumab) and osteoanabolic (teriparatide, abaloparatide, romosozumab) agents. Polypharmacy is associated with worse adherence to pharmacologic therapy. Thus, the selection of osteoporosis treatment should be individualized and based on a variety of factors, including underlying fracture risk (high vs very high risk), medical comorbidities, me...
Source: Clinics in Geriatric Medicine - September 13, 2022 Category: Geriatrics Authors: Megan McConnell, Albert Shieh Source Type: research
Polypharmacy in the Emergency Department
Polypharmacy in the emergency department (ED) presents additional challenges for older adults with acute illnesses but is also an opportunity for healthcare providers to prevent adverse drug events as well as the use of potentially inappropriate medications. Older patients have complex health-related needs and are at risk for medication-related complications during an ED visit. Implementing mitigating strategies of performing medication reconciliation and review, using existing implicit or explicit tools to evaluate medications, and deprescribing or de-escalating high-risk medications are critical to positive health outcom...
Source: Clinics in Geriatric Medicine - September 13, 2022 Category: Geriatrics Authors: Khai H. Nguyen, Vaishal Tolia, Laura A. Hart Source Type: research
Polypharmacy: A Continuing Challenge to Clinicians
We, clinicians, took an oath to cause no harm. One of the most common ways that clinicians can cause harm is by through prescribing unnecessary medications and/or prescribing medications that interact negatively with other medications. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - September 13, 2022 Category: Geriatrics Authors: Edward Schneider, Brandon K. Koretz Tags: Preface Source Type: research
Polypharmacy in Hypertension
Although hypertension is highly prevalent in older adults, treatment goals require both an understanding of the various guidelines available, as well as appreciation of the unique medical, cognitive, psychosocial, and functional heterogeneity of our individual geriatric patients that may place them outside those guidelines. As a patient ’s clinical status changes over time, clinicians may consider deprescribing their blood pressure medications when their risks begin to outweigh their benefits. Unique clinical circumstances and incorporating the time to benefit of hypertension control help guide clinical decision-making. ...
Source: Clinics in Geriatric Medicine - September 11, 2022 Category: Geriatrics Authors: Albert Bui Source Type: research
Polypharmacy in Treatment of Behavioral Issues in Dementia —Use of Atypical Antipsychotics
Behavioral and psychological symptoms of dementia (BPSD) may occur in most patients with dementia. Symptoms such as agitation, aggression, and psychosis often lead to higher rates of hospitalization, morbidity, and mortality. Despite the prevalence of BPSD, safe and effective treatment options are limited. This often leads to off-label prescribing and trends toward polypharmacy. Notwithstanding modest efficacy in BPSD, antipsychotics seem to be one of the most commonly prescribed medications in its treatment. Polypharmacy with antipsychotics is particularly troublesome due to the increased risk of potentially lethal advers...
Source: Clinics in Geriatric Medicine - September 11, 2022 Category: Geriatrics Authors: Jason Jalil, Pargol Nazarian, Hans F. von Walter Source Type: research
