Emerging approaches to polypharmacy among older adults
Raaj S Mehta1,2, Bharati D Kochar1,2, Korey Kennelty3,4
1Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Nature Aging
|April 28, 2023
Summary
Polypharmacy, the use of multiple medications in older adults, presents significant health challenges. This review emphasizes the need for a unified definition and explores strategies like deprescribing and precision medicine to mitigate risks.
Area of Science:
- Geriatric Medicine
- Clinical Pharmacology
- Public Health
Background:
- Polypharmacy is a critical health concern for the elderly population.
- It is associated with geriatric syndromes like frailty, falls, and cognitive decline.
- Research is hindered by inconsistent definitions, comorbidities, and limited prospective data.
Purpose of the Study:
- To review varying definitions of polypharmacy and advocate for a standardized approach.
- To critically evaluate strategies for medication reduction and deprescribing.
- To explore future research directions utilizing advanced analytics and precision medicine.
Main Methods:
- Literature review of polypharmacy definitions and management strategies.
- Appraisal of deprescribing interventions.
- Assessment of emerging technologies like multiomics and novel analytics.
Main Results:
- Significant heterogeneity exists in polypharmacy definitions, impeding research.
- Deprescribing shows promise in reducing adverse effects.
- Advanced technologies offer potential for personalized risk stratification.
Conclusions:
- A uniform definition of polypharmacy is crucial for advancing research.
- Effective deprescribing strategies are essential for patient safety.
- Precision medicine, powered by novel analytics and multiomics, will shape future polypharmacy management.
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