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Medication-related harm: a geriatric syndrome
Jennifer M Stevenson1,2, J Graham Davies1, Finbarr C Martin3
1Institute of Pharmaceutical Science, King's College London.
Age and Ageing
|October 31, 2019
Summary
Medication-related harm (MRH) in older adults is a growing public health issue. A new approach is needed, viewing MRH as a geriatric syndrome, to improve patient care and outcomes.
Area of Science:
- Geriatric Medicine
- Public Health
- Pharmacology
Background:
- Medication-related harm (MRH) is a significant global public health concern, particularly affecting older adults due to increased life expectancy, multimorbidity, and polypharmacy.
- The National Health Service (NHS) in England incurs substantial costs (approx. £400 million) due to MRH.
- Existing strategies for mitigating MRH in older adults, focusing on polypharmacy and medicine appropriateness, have yielded variable and often disappointing results.
Purpose of the Study:
- To advocate for a paradigm shift in addressing MRH in older adults by proposing it be recognized as a geriatric syndrome.
- To introduce a conceptual model that incorporates physiological changes and psychosocial factors influencing MRH.
- To emphasize the need for a coordinated, tailored approach across health and social care boundaries to proactively manage medicines in older adults.
Main Methods:
- Literature review and synthesis of existing knowledge on MRH and geriatric syndromes.
- Development of a conceptual model integrating physiological and psychosocial aspects of MRH.
- Analysis of current strategies and their limitations in managing MRH in older populations.
Main Results:
- Current approaches to MRH in older adults are insufficient, leading to continued harm and suboptimal outcomes.
- A broader approach, considering physiological and psychosocial factors, is necessary for effective MRH management.
- Viewing MRH as a geriatric syndrome can elevate its importance and encourage a more integrated care approach.
Conclusions:
- Medication-related harm should be recognized as a geriatric syndrome to highlight its significance and promote targeted interventions.
- A proactive, coordinated strategy across healthcare and social care sectors is essential for monitoring and reviewing medications in older adults.
- Adopting a new approach that considers the holistic needs of older adults is crucial to mitigate MRH and improve quality of life and clinical outcomes.
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