A literature review: polypharmacy protocol for primary care

Area of Science:

• Geriatric Medicine
• Clinical Pharmacy
• Health Services Research

Background:

• Polypharmacy, the use of multiple medications, is prevalent in older adults (65+).
• It poses significant risks, including adverse drug events (ADEs), falls, hospitalizations, and increased healthcare costs.
• Current primary care practices lack a standardized protocol for managing polypharmacy in this demographic.

Purpose of the Study:

• To critically evaluate existing literature on polypharmacy protocols for adults aged 65 and older in primary care.
• To identify potential strategies for reducing ADEs associated with polypharmacy.
• To highlight the need for a standardized protocol in primary care settings.

Main Methods:

• A comprehensive literature review of OVID, CINAHL, EBSCO, Cochrane Library, Medline, and PubMed databases.
• Keywords included: protocol, guideline, geriatrics, elderly, older adult, polypharmacy, and primary care.
• Inclusion criteria focused on interventions, protocols, or guidelines addressing polypharmacy and reducing ADEs, published after 1992. Qualitative and quantitative studies were considered.

Main Results:

• A significant gap exists in the literature regarding standardized polypharmacy protocols for primary care.
• Various strategies, mnemonics, algorithms, and guidelines were identified but not integrated into a cohesive primary care protocol.
• Screening tools like Beers Criteria and STOPP were found but not part of a standardized management protocol.

Conclusions:

• There is a critical need for a standardized protocol to manage polypharmacy in the elderly within primary care.
• Such a protocol could mitigate risks like falls and hospitalizations.
• Further research should focus on developing and evaluating standardized protocols to improve patient outcomes in geriatric polypharmacy.