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Polypharmacy in the Emergency Department.

Khai H Nguyen1, Vaishal Tolia2, Laura A Hart3

  • 1Department of Medicine, University of California, 8899 University Center Lane, Suite 400, MC 0877, San Diego, CA 92122, USA.

Clinics in Geriatric Medicine
|October 9, 2022
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Summary

Polypharmacy in the emergency department (ED) poses risks for older adults. Implementing medication review, reconciliation, and deprescribing strategies can prevent adverse drug events and optimize care for elderly patients.

Keywords:
Adverse drug eventsMedication reconciliationPolypharmacyPotentially inappropriate medications

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Area of Science:

  • Geriatric Medicine
  • Emergency Medicine
  • Clinical Pharmacology

Background:

  • Older adults frequently experience polypharmacy, increasing risks in the emergency department (ED).
  • Elderly patients are vulnerable to medication-related complications during acute illness and ED visits.
  • Polypharmacy management in the ED is crucial for preventing adverse drug events (ADEs).

Purpose of the Study:

  • To highlight the challenges and opportunities of polypharmacy in older adults within the ED setting.
  • To emphasize strategies for mitigating medication-related risks in elderly ED patients.
  • To promote optimization of pharmacologic interventions for geriatric patients in the ED.

Main Methods:

  • Performing comprehensive medication reconciliation and review.
  • Utilizing established implicit or explicit tools for medication evaluation.
  • Implementing deprescribing or de-escalation of high-risk medications.

Main Results:

  • Proactive medication management strategies can significantly reduce ADEs in older ED patients.
  • Systematic medication review identifies potentially inappropriate medications.
  • Deprescribing high-risk medications improves patient safety and health outcomes.

Conclusions:

  • Effective polypharmacy management in the ED is essential for improving geriatric patient outcomes.
  • Medication reconciliation, review, and deprescribing are critical interventions.
  • Optimizing pharmacologic care for older adults in the ED prevents ADEs and enhances safety.