Polypharmacy Risks in the Elderly

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Polypharmacy is a term used to describe a situation where a person is taking a number of different drugs simultaneously, usually more than are medically necessary.

 

It is more common among the elderly, with the highest incidence occurring among people in nursing homes. Research has shown that almost half of older adults take one or more medications that are not medically necessary and this polypharmacy has negative clinical manifestations. Here are a few of those negative consequences.

 

Adverse drug events

Studies have shown that people taking five or more medications had double the risk of experiencing an adverse drug event than those taking fewer than five drugs. Among people in nursing homes, adverse drug events are twice as high among those taking nine or more drugs than those taking fewer than nine drugs.

 

Drug interactions

For people with polypharmacy, drug interactions are much more likely. The likelihood of a drug interaction increases with the number of drugs a person is taking. For example, the risk of a drug interaction increased by 50 percent in a person taking five to nine different drugs compared to those taking fewer, and it jumped by 100 percent in those taking 20 or more drugs.

 

Interactions between drugs are a common type of adverse drug event, even resulting in medication-related hospital stays, but they are completely preventable with the proper precautions.

 

Non-adherence

The more drugs a person is taking, the greater the likelihood they are not following the prescribed regimen for taking each medication.

 

Physical decline

Polypharmacy is associated with physical decline in older adults, including the inability to perform the basic activities of daily living.

 

Cognitive problems, falls, urinary problems

Taking multiple drugs can lead to urinary incontinence and cognitive difficulty, even delirium.

 

Evidence has shown that unnecessary use of drugs can be curtailed with proper precautions, such as adding a clinical pharmacist to an inpatient healthcare team. Studies designed to improve the quality of medication regimens in older adults have also shown that polypharmacy can be controlled.

 

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