Polypharmacy concerns in the geriatric population

Abstract

With the geriatric population steadily increasing and receiving primary care, it is important for the osteopathic family physician to have knowledge about safely prescribing to the geriatric patient. Polypharmacy, the use of 5 or more medications or the use of any medication that is not clinically warranted, presents many risks to the elderly patient and increases morbidity and mortality. Irrespective of a patient's medical problems, polypharmacy has proven to be associated with an increased risk of falls as well as fracture. Drug-related cognitive changes as well as worsening of underlying dementia may be attributable to polypharmacy. Certain types of medications are more likely to cause cognitive changes, but any medication may cause a status change in the geriatric patient. Safe prescribing to the geriatric patient involves understanding the physiological changes of aging and adjusting the dosages accordingly, to avoid adverse events such as acute renal failure. Many resources (including the Beers Criteria, screening tool to alert doctors to right treatments [START] tool, and screening tool of older persons' potentially inappropriate prescriptions [STOPP] tool) exist to assist the osteopathic family physician in safely prescribing to the geriatric patient. Utilizing these resources for a thorough medication review for each geriatric patient would enable the osteopathic family physician to implement safe prescribing practices thus decreasing risks to the patient.