Polypharmacy, or use of multiple medications, is common among older adults with multiple chronic conditions and carries high risk of unwanted drug interactions and reactions.
Adverse drug reactions are responsible for a quarter of acute geriatric hospital admissions and occur in 35% of community-dwelling older adults.
Beyond simply posing a high “pill burden” to older adults, use of multiple medications often results in patients receiving duplicate medications, without an appropriate clinical indication, prescribed on multiple dosing schedules from multiple prescribers and filled at multiple pharmacies. For vulnerable elders with existing cognitive impairment and difficulty completing instrumental activities of daily living, negative outcomes are likely.
Multiple medications can lead to changes in older adults’ cognitive status, physical function, and predispose them to developing harmful geriatric syndromes, such as delirium, frailty, falls, fractures, and repeat hospitalization.
Patients at highest risk of negative effects from polypharmacy include individuals over age 85, patients with renal impairment, patients with low body weight and poor nutrition, patients diagnosed with six or more chronic diseases, patients taking over 12 dosages of medications daily, and individuals with a history of adverse drug reactions.