Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

11
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...
11
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

6
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...
6
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

6
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...
6
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

3
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...
3
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

5
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...
5
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

7
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...
7

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Trajectories of Treatment Disruption for Chronic Outpatient Medications for U.S. Veterans During Drug Shortages.

Pharmacoepidemiology and drug safety·2026
Same author

Reducing sleep medication via parallel delivery of clinical pharmacist-led deprescribing and clinician-supervised asynchronous CBT for insomnia: the SEDATIVE trial.

Journal of behavioral medicine·2026
Same author

Compliance with the Veterans Health Administration's Pharmacy Benefit Management guidance for duration of clopidogrel following peripheral vascular interventions: a retrospective cohort study.

Journal of managed care & specialty pharmacy·2026
Same author

Development of a decision aid to help dually enrolled veterans make informed choices on medication sourcing.

Journal of managed care & specialty pharmacy·2026
Same author

Drug supply chain disruptions and outpatient medication shortages in the Veterans Health Administration, 2017-2020.

Exploratory research in clinical and social pharmacy·2026
Same author

Discontinuation of Medications With Limited Benefit at End of Life in Community-Dwelling Older Veterans.

Journal of the American Geriatrics Society·2026

Related Experiment Video

Updated: Oct 3, 2025

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

7.7K

Development of a Metric to Detect and Decrease Low-Value Prescribing in Older Adults.

Thomas R Radomski1,2,3, Alison Decker1,3, Dmitry Khodyakov4

  • 1Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

JAMA Network Open
|February 15, 2022
PubMed
Summary
This summary is machine-generated.

A new metric, EVOLV-Rx, identifies 18 key low-value prescribing practices in older adults. This tool aims to improve medication safety and ensure high-value care for seniors.

More Related Videos

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
06:52

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

10.0K
Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
11:21

Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data

Published on: July 27, 2018

8.3K

Related Experiment Videos

Last Updated: Oct 3, 2025

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

7.7K
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
06:52

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

10.0K
Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
11:21

Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data

Published on: July 27, 2018

8.3K

Area of Science:

  • Health Services Research
  • Geriatric Pharmacy
  • Clinical Quality Measurement

Background:

  • Existing metrics for low-value care often overlook medications, creating a gap in assessing prescribing practices.
  • Systematic measurement of low-value prescribing is crucial for improving patient outcomes and healthcare efficiency.

Purpose of the Study:

  • To develop a scalable metric, EVOLV-Rx, to detect and reduce low-value prescribing in older adults.
  • To incorporate diverse stakeholder perspectives into the development of quality indicators for prescribing.

Main Methods:

  • A modified-Delphi method was used with a 15-member expert panel of physicians and pharmacists.
  • The RAND ExpertLens platform facilitated 3 rounds of rating and discussion on candidate low-value prescribing practices.
  • Practices were evaluated based on scientific validity and clinical usefulness using a 9-point Likert scale.

Main Results:

  • The expert panel identified 18 discrete low-value prescribing practices for inclusion in EVOLV-Rx.
  • These 18 practices achieved high scientific validity and clinical usefulness ratings (median scores ≥6.5).
  • The process refined criteria, leading to a robust set of indicators for low-value prescribing.

Conclusions:

  • EVOLV-Rx was successfully developed, comprising 18 salient low-value prescribing practices for older adults.
  • Implementation of EVOLV-Rx can enhance the detection of inappropriate medications, reduce polypharmacy, and promote high-value care.
  • This metric supports better medication management and improved health outcomes for the elderly population.