Dr. Aviva G. Asnis-Alibozek
Purpose: The purpose of this article is to define polypharmacy, both appropriate and problematic, in the setting of geriatric medicine and how to use deprescribing to decrease adverse drug reactions.
Method: A PubMed literature search was conducted with search terms polypharmacy, deprescribing, and elderly which resulted in 1,673 results. Filtered by ages 65 and up along with articles from the prior five years this decreased to 1,166 results. Narrowing down the articles by relevance, nineteen articles were selected to be utilized in this clinical review.
Results: Evidence-based medicine has shown a correlation between polypharmacy and the increase in morbidity and mortality in the elderly population along with other adverse outcomes.
Conclusion: Appropriate polypharmacy is prescribing multiple medications for multiple conditions using the best available evidence and optimizing prescriptions. Problematic polypharmacy is the prescribing of multiple medications inappropriately or where the patient does not benefit from the medication.2 Deprescribing is defined as the withdrawal from medications with the supervision of a healthcare professional.3 Problematic polypharmacy has been linked to increased morbidity and mortality in the elderly population and it has been shown that deprescribing reduces adverse effects of multiple medications and increases medication adherence.3
Williams MK. Polypharmacy in the Elderly: Recognizing and Deprescribing. Lynchburg Journal of Medical Science. 2022; 4(4).
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