Feature Article

How to optimise use of medications in the elderly

Feature Article

How to optimise use of medications in the elderly

Peter I Pillans, Michael S Roberts

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Abstract

Optimising medication use in the elderly is challenging. After an accurate drug history and comprehensive medication review, compliance and polypharmacy should be addressed. With each prescription, it is best to prioritise and simplify, by using the lowest feasible doses and the smallest number of medicines, with the simplest dose regimen.

Key Points

  • Regular medication review is essential for optimising medication use in the elderly.
  • Overprescribing or polypharmacy should be specifically addressed by prioritising and simplifying.
  • Use the lowest feasible dose to achieve the desired effect in the elderly (often less than half the usual adult dose).
  • Decreased renal and hepatic clearance and impaired homoeostasis combined with polypharmacy result in frequent adverse reactions.
  • Compliance is inversely related to the number of medications.
  • An accurate drug history and an up-to-date medication record are essential.