An Update on Medication Use in Older Adults: a Narrative Review

Abstract

Purpose of Review The global phenomenon of population aging is impacting the health and care needs of society. The use of medications by older adults is acknowledged to be the most common form of medical intervention for many acute and chronic conditions and prescribing in this population continues to increase. In this narrative review, we summarise the age-related factors that should be considered when prescribing for older adults, address some of the perennial challenges related to medicine use in older people, and highlight important emerging research in this area. Recent Findings A range of age-related factors should be considered when prescribing for older adults. However, the evidence base still lacks data pertaining to older adults due to their continued under-representation in clinical trials. Multimorbidity, polypharmacy, and inappropriate prescribing continue to remain prevalent among older adults, although recent research has been focused on the development and evaluation of complex interventions to address these challenges. Summary Further high-quality studies of interventions to improve and support medication use in older adults are needed, ensuring that older adults are well represented in such trials and consideration is given to the measurement of patient- and provider-focused outcomes.

Patterns of medication management and associated medical and clinical features among home-dwelling older adults: a cross-sectional study in central Portugal

“…Considering the sample's combination of multimorbidity, polypharmacy and a high prevalence of frailty, our participants were exposed to a high risk of MRPs. This nding was corroborated in other studies [44][45] reporting that age-related factors such as multimorbidity, chronic pain, polypharmacy and frailty should be considered when prescribing medication. Taken together, these ndings lead us to recommend the implementation of strategies to reduce modi able risk factors-such as prefrailty and moderate frailty-and to optimise medication adherence, reduce over-use and avoid under-use, all of which could be effective measures for decreasing the risk of MRPs and helping older adults to remain in their homes.…”

Insight into appropriate medication prescribing for elderly in the COVID-19 era

“…Pharmacokinetics in the elderly is much more complex and consequently, the list of contraindicated or relatively contraindicated medications is greater. Polypharmacy, inappropriate medication prescribing and multimorbidity in the elderly result in inherent challenges[ 1 ]. The recent coronavirus disease 2019 (COVID-19) pandemic brought the complexity of this issue into sharp focus.…”

Deprescribing in Older Poly-Treated Patients Affected with Dementia

“…The number of drugs taken daily increases with age and the number of prescribers [ 2 ]. Therefore, the poly-treated patient is usually an older patient who uses five or more drugs with an increased risk of adverse drug reactions (ADR).…”