Preventing Polypharmacy in Older Adults

Kathleen Woodruff MS, CRNP

Disclosures

Am Nurs Today. 2010;5(10) 

In This Article

Abstract and Introduction

Introduction

Polypharmacy refers to the effects of taking multiple medications concurrently to manage coexisting health problems, such as diabetes and hypertension. Too often, polypharmacy becomes problematic, such as when patients are prescribed too many medications by multiple healthcare providers working independently of each other. Also, drug interactions can occur if no single healthcare provider knows the patient's complete medication picture.

Among older adults, polypharmacy is a common problem. Currently, 44% of men and 57% of women older than age 65 take five or more medications per week; about 12% of both men and women take 10 or more medications per week. These agents include both prescription and over-the-counter (OTC) preparations, such as vitamin and mineral supplements and herbal products.

The most commonly used drugs—acetaminophen, ibuprofen, and aspirin—are available OTC and contribute significantly to adverse drug reactions in the elderly. Generally, the more drugs a person takes, the greater the risk of adverse reactions and drug interactions. The drug categories most commonly involved in adverse reactions are cardiovascular agents, antibiotics, diuretics, anticoagulants, hypoglycemics, steroids, opioids, anticholinergics, benzodiazepines, and nonsteroidal anti-inflammatory drugs.

Nurses have a unique opportunity to help identify patients at risk for inappropriate polypharmacy and to educate patients and families about risk reduction. This article explores potential problems related to multiple drug use in the elderly, including age-related alterations in response to drugs, drug-drug and drug-herbal interactions, and nonadherence with the medication regimen. It also identifies strategies to minimize these risks.

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