Polypharmacy

Selected articles and automatically-renewing searches exploring the topic of Polypharmacy in the older adult

Core Concepts

Advances in Aging Research Lecture Series: James Kloster, RPh., CGP Perspectives in Medication Safety in the Elderly  July 17, 2008  

Shrank WH, Polinski JM, Avorn J. Quality indicators for medication use in vulnerable elders. J Am Geriatr Soc. 2007;55 Suppl 2:S373-82.

Key Review Articles

Ballantine, NH. Polypharmacy in the elderly: Maximizing benefit, minimizing harm. Crit Care Nurs Q. 2008;31( 1):40-45.

Ferrario CG. Geropharmacology: A primer for advanced practice acute care and critical care nurses, part I. AACN Adv Crit Care. 2008;19( 1):23-35; quiz 36-7.

Fick DM, Cooper JW, Wade WE, Waller JL, MacleanJR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts. Arch Intern Med.2003;163( 22):2716-2724..

Fulton MM, Allen ER. Polypharmacy in the elderly: A literature review. J Am Acad Nurse Pract. 2005;17( 4):123-132.  

Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother. 2007;5( 4):345-351.

Levy HB, Marcus EL, Christen C. Beyond the beers criteria: A comparative overview of explicit criteria. Ann Pharmacother. 2010 Dec;44(12):1968-75. PubMed PMID: 21081709.

Meeks TW, Culberson JW, Horton MS. Medications in long-term care: when less is more. Clin Geriatr Med. 2011 May;27(2):171-91. PubMed PMID: 21641504

Milton JC, Hill-Smith I, Jackson SH. Prescribing for older people. BMJ. 2008;336( 7644):606-609. 

Woolcott JC, Richardson KJ, Wiens MO, Patel B, Marin J, Khan KM, Marra CA. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169(21):1952-60. PubMed PMID: 19933955. 

top

Epidemiology

Alkema GE, Wilber KH, Simmons WJ, Enguidanos SM, Frey D. Prevalence of potential medication problems among dually eligible older adults in Medicaid waiver services. Ann Pharmacother. 2007;41( 12):1971-1978.  

Boudreau DM, Yu O, Gray SL, Raebel MA, Johnson J, Larson EB. Concomitant use of cholinesterase inhibitors and anticholinergics: prevalence and outcomes. J Am Geriatr Soc. 2011 Nov;59(11):2069-76. doi: 10.1111/j.1532-5415.2011.03654.x.PubMed PMID: 22091958.

Budnitz DS, Lovegrove MC, Shehab N, Richards CL. Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med. 2011 Nov 24;365(21):2002-12. PubMed PMID: 22111719.

Egger SS, Bachmann A, Hubmann N, Schlienger RG, Krahenbuhl S. Prevalence of potentially inappropriate medication use in elderly patients: Comparison between general medical and geriatric wards. Drugs Aging. 2006;23( 10):823-837.

Fick DM, Mion LC, Beers MH, L Waller J. Health outcomes associated with potentially inappropriate medication use in older adults. Res Nurs Health. 2008;31( 1):42-51.

Hamilton H, Gallagher P, Ryan C, Byrne S, O'Mahony D. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients.Arch Intern Med. 2011 Jun 13;171(11):1013-9. PubMed PMID: 21670370.

Hanlon JT, Pieper CF, Hajjar ER, et al. Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay. J Gerontol A Biol Sci Med Sci. 2006;61( 5):511-515.

Juurlink DN, Mamdani M, Kopp A, Laupacis A, Redelmeier DA. Drug-drug interactions among elderly patients hospitalized for drug toxicity. JAMA. 2003 Apr 2;289(13):1652-8. PubMed PMID: 12672733.

Lattanzio F, Laino I, Pedone C, Corica F, Maltese G, Salerno G, Garasto S, Corsonello A, Incalzi RA; on behalf of the PharmacosurVeillance in the elderly Care (PVC) Study Group. Geriatric Conditions and Adverse Drug Reactions in Elderly Hospitalized Patients. J Am Med Dir Assoc. 2011 PubMed PMID: 21621472.

Spinewine A, Schmader KE, Barber N, et al. Appropriate prescribing in elderly people: How well can it be measured and optimised? Lancet.2007;370( 9582):173-184

Rossi MI, Young A, Maher R, et al. Polypharmacy and health beliefs in older outpatients. Am J Geriatr Pharmacother. 2007;5( 4):317-323.

Simon SR, Chan KA, Soumerai SB, et al. Potentially inappropriate medication use by elderly persons in U.S. health maintenance organizations, 2000-2001. J Am Geriatr Soc. 2005;53( 2):227-232.

top

Pathophysiology

Cusack BJ. Pharmacokinetics in older persons. Am J Geriatr Pharmacother. 2004;2( 4):274-302

McLean AJ, Le Couteur DG. Aging biology and geriatric clinical pharmacology. Pharmacol Rev. 2004;56( 2):163-184.

Schwartz JB. The current state of knowledge on age, sex, and their interactions on clinical pharmacology. Clin Pharmacol Ther. 2007;82( 1):87-96

top

Assessment and Management

Bangalore S, Kamalakkannan G, Parkar S, Messerli FH. Fixed-dose combinations improve medication compliance: A meta-analysis. Am J Med. 2007;120( 8):713-719.

Clegg A, Young JB. Which medications to avoid in people at risk of delirium: a systematic review. Age Ageing. 2011 Jan;40(1):23-9. Epub 2010 Nov 9. Review. PubMed PMID: 21068014.

Ernsth Bravell M, Westerlind B, Midlöv P, Östgren CJ, Borgquist L, Lannering C, Mölstad S. How to assess frailty and the need for care? Report from the Study of Health and Drugs in the Elderly (SHADES) in community dwellings in Sweden. Arch Gerontol Geriatr. 2011 Jul-Aug;53(1):40-5. PubMed PMID: 20678818.

Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy.Arch Intern Med.  2010;170(18):1648-54. PubMed PMID: 20937924

Hamilton H, Gallagher P, Ryan C, Byrne S, O'Mahony D. Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug  events in older hospitalized patients. Arch Intern Med. 2011 Jun 13;171(11):1013-9. PubMed PMID: 21670370

Mallet L, Spinewine A, Huang A.The challenge of managing drug interactions in elderly people. Lancet. 2007;370( 9582):185-19.

Onder G, Petrovic M, Tangiisuran B, Meinardi MC, Markito-Notenboom WP, Somers A, Rajkumar C, Bernabei R, van der Cammen TJ. Development and validation of a score to assess risk of adverse drug reactions among in-hospital patients 65 years or older: the GerontoNet ADR risk score. Arch Intern Med. 2010 Jul 12;170(13):1142-8. PubMed PMID: 20625022.

Steinman MA, Hanlon JT. Managing medications in clinically complex elders: "There's got to be a happy medium". JAMA. 2010 Oct 13;304(14):1592-601. PubMed PMID: 20940385.

top

PubMed Alerts

Polypharmacy in the Older Adult

top

Practice Guidelines

Bergman-Evans B. Evidence-based guideline: Improving medication management for older adult clients. J Gerontol Nurs. 2006;32( 7):6-14.

National Guideline Clearinghouse (NGC). Guideline summary: Improving medication management for older adult clients. In: National Guideline Clearinghouse (NGC) [website]. Rockville (MD): Available: http://www.guideline.gov

Health Services and Models of Care 

Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med. 2010 Oct 11;170(18):1648-54. PubMed PMID: 20937924.

Holmes HM, Sachs GA, Shega JW, Hougham GW, Cox Hayley D, Dale W. Integrating palliative medicine into the care of persons with advanced dementia: Identifying appropriate medication use. J Am Geriatr Soc. 2008. 

Lewis NJ, Bugdalski-Stutrud C, Abate MA, Blommel M, Wu CH, Gaither CA. The medication assessment program: Comprehensive medication assessments for persons taking multiple medications for chronic diseases. J Am Pharm Assoc (2003). 2008;48( 2):171-180.

Rocchiccioli JT, Sanford J, Caplinger B. Polymedicine and aging. enhancing older adult care through advanced practitioners. GNPs and elder care pharmacists can help provide optimal pharmaceutical care. J Gerontol Nurs. 2007;33( 7):19-24.

van Gaal BG, Schoonhoven L, Mintjes JA, Borm GF, et al. Fewer adverse events as a result of the SAFE or SORRY? programme in hospitals and nursing homes. part i: primary outcome of a cluster randomised trial. Int J Nurs Stud. 2011 Sep;48(9):1040-8. doi: 0.1016/j.ijnurstu.2011.02.017. PubMed PMID: 21419411.

top

Related Issues:(Social Factors, Undermedication, Health Disparities)

Green JL, Hawley JN, Rask KJ. Is the number of prescribing physicians an independent risk factor for adverse drug events in an elderly outpatient population? Am J Geriatr Pharmacother. 2007;5( 1):31-39.

Jervis LL, Shore J, Hutt E, Manson SM. Suboptimal pharmacotherapy in a tribal nursing home. J Am Med Dir Assoc. 2007;8( 1):1-7.

Rossi MI, Young A, Maher R, et al. Polypharmacy and health beliefs in older outpatients. Am J Geriatr Pharmacother. 2007;5( 4):317-323. 

Steinman MA, Maaravi Y, Walter LC, Hammerman-Rozenberg R, Stessman J. Evolution of medication use in Jerusalem elders: Results from the Jerusalem longitudinal study. Drugs Aging. 2007;24( 2):133-145.

top

Interdisciplinary Issues

Binch J, Beamon R, Clontz S, et al. Incorporating medication regimen reviews into the interdisciplinary care planning process. Geriatr Nurs. 2005;26( 2):89-93.

Gaertner J, Ruberg K, Schlesiger G, Frechen S, Voltz R. Drug interactions in palliative care - it's more than cytochrome P450. Palliat Med. 2011 Jul 7. PubMed PMID: 21737479.   

Hanlon JT, Sloane RJ, Pieper CF, Schmader KE. Association of adverse drug reactions with drug-drug and drug-disease interactions in frail older outpatients. Age Ageing. 2011;40(2):274-7. PubMed PMID: 21177281

Orwig D, Rickles NM, Martin LG. Methodological issues in pharmacotherapy research in older adults. Am J Geriatr Pharmacother. 2011 Jun;9(3):173-89.. PubMed PMID: 21636042.

Sokol KC, Knudsen JF, Li MM. Polypharmacy in older oncology patients and the need for an interdisciplinary approach to side-effect management. J Clin Pharm Ther. 2007;32( 2):169-175.

Weiss BD. Medication-Induced Hypokalemia: A Common Problem Elder Care: A Resource for Interprofessional Providers. February 2010 (updated June 2010).

top