Polypharmacy: the benefits of reducing medications for older adults

Polypharmacy: the benefits of reducing medications for older adults
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There are benefits associated with reducing the number of medication prescriptions for older adults to tackle the issue of polypharmacy.

The research from The Gerontological Society of America has been published in the journal Public Policy & Aging Report. It assessed whether deprescribing drugs can be used as a solution to polypharmacy. In the report, deprescribing is defined as “the systematic process of identifying and discontinuing drugs in instances in which existing or potential harms outweigh existing or potential benefits within the context of an individual patient’s care goals, current level of functioning, life expectancy, values, and preferences.”

Polypharmacy

The study identified several contributing factors to polypharmacy in older adults:

  • “An increasing complexity of health care delivery, irrespective of the national setting, leading to problems of coordination between caregivers, physicians, and patients;
  • The rise of co-morbidity and chronic long-term illnesses as the population ages;
  • The huge numbers of available pharmaceuticals and their widespread use;
  • The construction of guidelines based on single diseases, randomised control trials of low external validity, and drugs untested in the older population;
  • Marginalisation and dis-empowerment of older patients, with the absence of shared decision-making; and
  • A culture in Western societies that is expectant of medical intervention at all levels.”

Reducing the number of medications

The study found that deprescribing may have actually have surprising benefits, and weighs up the ethical and policy issues related to deprescribing and how to address barriers to deprescribing.

Goodwin and Kaskie said: “We know more than ever about the current state of polypharmacy, a modern epidemic which has the potential to blight the lives of millions of older people. Yet progress is slow. Let us hope that by extending our understanding and the possibilities for improvement, we reduce the risks and increase the health and quality of life of our aging populations.”

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