Related Experiment Video
Updated: Mar 2, 2026
04:34
Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia
Published on: February 17, 2023
1.7K
Polypharmacy in multimorbid older adults: protocol for a systematic review
Caroline Sirois1,2,3,4,5, Marie-Laure Laroche6,7, Line Guénette8,9
1Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Québec, Canada. caroline.sirois@fmed.ulaval.ca.
Systematic Reviews
|May 21, 2017
Summary
Polypharmacy, the use of multiple medications, is rising in older adults with multiple conditions. This review synthesizes definitions, factors, and outcomes like hospitalizations and mortality associated with this complex issue.
Area of Science:
- Gerontology
- Clinical Pharmacy
- Public Health
Background:
- Polypharmacy (concurrent use of multiple medications) is increasing, particularly in older adults with multiple comorbidities.
- Despite negative connotations and adverse event associations, population-scale assessment is needed due to rising prevalence.
- Lack of consensus on polypharmacy definitions, contributing factors, and outcomes complicates research.
Purpose of the Study:
- To systematically review literature on polypharmacy in individuals aged 65 and over with multimorbidity.
- To identify definitions of polypharmacy used in this demographic.
- To ascertain predisposing/concurrent factors and describe positive/negative health outcomes, including hospitalizations, mortality, and costs.
Main Methods:
- Systematic review of publications from 2004-2016.
- Searches across multiple databases (e.g., MEDLINE, Embase, Google Scholar) for studies on polypharmacy, older individuals, multimorbidity, and outcomes.
- Two independent reviewers screened articles, extracted data, and assessed study quality; meta-analyses planned if heterogeneity is low.
Main Results:
- (Not yet available as this is a protocol.)
- (Not yet available as this is a protocol.)
- (Not yet available as this is a protocol.)
Conclusions:
- This systematic review will clarify polypharmacy conceptualizations and its association with health outcomes in older, multimorbid populations.
- Findings will inform public health surveillance using administrative databases.
- (Not yet available as this is a protocol.)
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
328
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
328
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
287
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
287
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
273
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
273
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
302
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
302
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
765
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
765
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
291
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
291