Multiple Diseases and Polypharmacy in the Elderly: Challenges for the Internist of the Third Millennium
Open Access
- 1 January 2011
- journal article
- review article
- Published by SAGE Publications in Journal of Comorbidity
- Vol. 1 (1), 28-44
- https://doi.org/10.15256/joc.2011.1.4
Abstract
The pattern of patients admitted to internal medicine wards has dramatically changed in the last 20–30 years. Elderly people are now the most rapidly growing proportion of the patient population in the majority of Western countries, and aging seldom comes alone, often being accompanied by chronic diseases, comorbidity, disability, frailty, and social isolation. Multiple diseases and multimorbidity inevitably lead to the use of multiple drugs, a condition known as polypharmacy. Over the last 20–30 years, problems related to aging, multimorbidity, and polypharmacy have become a prominent issue in global healthcare. This review discusses how internists might tackle these new challenges of the aging population. They are called to play a primary role in promoting a new, integrated, and comprehensive approach to the care of elderly people, which should incorporate age-related issues into routine clinical practice and decisions. The development of new approaches in the frame of undergraduate and postgraduate training and of clinical research is essential to improve and implement suitable strategies meant to evaluate and manage frail elderly patients with chronic diseases, comorbidity, and polypharmacy.Keywords
This publication has 131 references indexed in Scilit:
- Managing Medications in Clinically Complex EldersJAMA, 2010
- Individualized Medical Decision MakingJAMA Internal Medicine, 2010
- Medical Care for the Final Years of LifeJAMA, 2009
- Potentially severe drug interactions in elderly outpatients: results of an observational study of an administrative prescription databaseJournal of Clinical Pharmacy & Therapeutics, 2009
- A Framework for Tailoring Clinical Guidelines to Comorbidity at the Point of CareArchives of Internal Medicine, 2007
- Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalistsJournal of Hospital Medicine, 2007
- Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care PhysiciansJAMA, 2007
- Clinical Practice Guidelines and Quality of Care for Older Patients With Multiple Comorbid DiseasesJAMA, 2005
- Impact of inappropriate drug use among hospitalized older adultsEuropean Journal of Clinical Pharmacology, 2005
- Studies of Illness in the AgedJAMA, 1963