Appropriate Use of Medications in the Elderly

• Published in: Reichel's Care of the Elderly pp. 48 - 58
• Main Authors: Umland, Elena M., Sanoski, Cynthia A., King, Amber
• Format: Book Chapter
• Language: English
• Published: United States Cambridge University Press 09.02.2009
• Subjects: Geriatric medicine; Geriatric nursing
• ISBN: 0521689554; 9780521689557; 0521869293; 9780521869294
• DOI: 10.1017/CBO9780511575952.006

INTRODUCTIONThirty-five million people, 12% of the population of the United States, are older than the age of 65 years. These individuals consume 25% of all prescription medications. Being such large consumers of prescription medications as well as being at increased risk for adverse drug reactions (ADRs) from their use, this population is in need of heightened diligence in prescribing. Some reasons for the increased attention to prescribing in the elderly population include but are not limited to: 1) the increased sensitivity to drug effects that this patient population experiences secondary to pharmacokinetic and pharmacodynamic changes that naturally occur with aging; 2) the less than optimal medication adherence rates that have been observed within this patient population; 3) the current state of not fully following and applying treatment guidelines to these patients; and 4) the high incidence of both underprescribing and polypharmacy among these patients. Furthermore, this increased diligence is necessary, as this population is medically more complicated with the usual presence of several concomitant disease states. Addressing such issues by using an interdisciplinary team–based approach should aid in reducing medication errors.Although the reduction in medication errors in all patients is of extreme importance, the gravity of the importance in those patients older than the age of 65 years is indisputable when more than 800,000 preventable adverse drug events (ADEs) are projected to occur in long-term care settings. These projected events do not include errors of omission.