An update on the clinical consequences of polypharmacy in older adults: a narrative review
Top Cited Papers
Open Access
- 2 December 2018
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Opinion on Drug Safety
- Vol. 17 (12), 1185-1196
- https://doi.org/10.1080/14740338.2018.1546841
Abstract
Introduction: Polypharmacy, the use of multiple medications by one individual, is increasingly common among older adults. Caring for the growing number of older people with complex drug regimens and multimorbidity presents an important challenge in the coming years. Areas covered: This article reviews the international trends in the prevalence of polypharmacy, summarizes the results from previous reviews on polypharmacy and negative health outcomes, and updates a previous review on the clinical consequences of polypharmacy by focusing on studies published after 2013. This narrative review, which is based on a literature search in MEDLINE and EMBASE from January 1990 to June 2018, was undertaken to identify relevant articles. Search terms included variations of polypharmacy and multiple medications. Expert opinion: The prevalence of polypharmacy is increasing worldwide. More than half of the older population is exposed to polypharmacy in some settings. Polypharmacy is associated with a broad range of clinical consequences. However, methods to assess the dangers of polypharmacy should be refined. In our opinion, the issue of ‘confounding by multimorbidity’ has been underestimated and should be better accounted for in future studies. Moreover, researchers should develop more clinically relevant definitions of polypharmacy, including measures of inappropriate or problematic polypharmacy.Keywords
Funding Information
- Vetenskapsrådet (2015-03618)
This publication has 95 references indexed in Scilit:
- A population-based study on the association between acute renal failure (ARF) and the duration of polypharmacyBMC Nephrology, 2012
- Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional studyThe Lancet, 2012
- Electronic Prescribing and Other Forms of Technology to Reduce Inappropriate Medication Use and Polypharmacy in Older People: A Review of Current EvidenceClinics in Geriatric Medicine, 2012
- Drug use in centenarians compared with nonagenarians and octogenarians in Sweden: a nationwide register-based studyAge and Ageing, 2011
- Increasing polypharmacy - an individual-based study of the Swedish population 2005-2008BMC Clinical Pharmacology, 2010
- Relationship between polypharmacy and underprescribingBritish Journal of Clinical Pharmacology, 2007
- Clinically important drug-disease interactions and their prevalence in older adultsClinical Therapeutics, 2006
- Clinical Practice Guidelines and Quality of Care for Older Patients With Multiple Comorbid DiseasesJAMA, 2005
- Polypharmacy in the elderly: A literature reviewJournal of the American Academy of Nurse Practitioners, 2005
- Validation of a combined comorbidity indexJournal of Clinical Epidemiology, 1994