ABSTRACT
Multiple co-morbidities lead to multiple medications, which increase the risk of adverse drug reactions and reduce the likelihood of accurate adherence to the regimen. Medications directly lead to around 3%–12% of admissions and may play a minor contributory role to many more, through a variety of mechanisms. Plus there are changes in pharmacokinetics and pharmacodynamics that tend to increase the risk of toxicity. Multiple co-morbidities lead to multiple medications, which increase the risk of adverse drug reactions and reduce the likelihood of accurate adherence to the regimen. The definition of polypharmacy can vary but is often used for patients on four or more regular medications. Basic good practice in prescribing for older patients includes documentation of the indication, education of the patient, monitoring of response to treatment and for adverse effects, avoiding drugs most likely to cause side effects, and regular review of the ongoing need for each medication.
