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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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 not...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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

Pharmacodynamics in Geriatric Patients: Effects of Age

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...

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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Published on: November 9, 2016

Resolving Medication-Related Problems in Older Adults through a Multidisciplinary Approach in Korea's Hospital-Based

Hyunwoo Chae1, Young-Mi Ah2, Sunmee Jang3

  • 1College of Pharmacy, Seoul National University, Seoul, Korea.

Yonsei Medical Journal
|January 21, 2026
PubMed
Summary

Hospital teams effectively manage polypharmacy in older adults, identifying medication problems and making necessary prescription changes. Targeting very elderly patients and those on many medications improves program efficiency.

Keywords:
Multidisciplinary care teamadverse drug reactionmedication therapy managementpolypharmacy

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Area of Science:

  • Geriatric Medicine
  • Clinical Pharmacy
  • Public Health

Background:

  • Polypharmacy is a major health concern for older adults.
  • A national hospital-based Polypharmacy Management Program (PMP) was implemented.
  • This study assesses the PMP's initial performance and identifies factors linked to medication-related problems (MRPs).

Purpose of the Study:

  • To evaluate the effectiveness of a multidisciplinary Polypharmacy Management Program (PMP).
  • To identify factors associated with medication-related problems (MRPs) that lead to prescription changes in older adults.
  • To assess the performance of a national, hospital-based PMP.

Main Methods:

  • Retrospective analysis of 2021 PMP data from 1740 patients across 33 hospitals.
  • Examination of medication review and intervention outcome records, along with patient demographics.
  • Multivariable logistic regression to identify predictors of prescription modifications.

Main Results:

  • Medication-related problems (MRPs) were identified in 73.5% of patients, averaging 2.7 per patient.
  • Common MRPs included potentially inappropriate medications (58.7%), drug interactions (46.9%), and adverse drug reactions (26.2%).
  • Factors predicting prescription modifications included advanced age (≥85 years), high medication count (≥20), and use of specific drug classes.

Conclusions:

  • Multidisciplinary hospital teams successfully identify and resolve MRPs in older Korean adults with polypharmacy.
  • Optimizing PMP efficiency can be achieved by targeting high-risk subgroups, such as the very elderly and those with high medication burdens.
  • Further research is needed on the long-term clinical and economic outcomes of PMP interventions.