@article{ref1,
title="Polypharmacy management in older patients",
journal="Mayo Clinic proceedings",
year="2021",
author="Takahashi, Paul Y. and Giddings Connolly, Ryan M. and Hoel, Robert William",
volume="96",
number="1",
pages="242-256",
abstract="Medications to treat disease and extend life in our patients often amass in quantities, resulting in what has been termed &quot;polypharmacy.&quot; This imprecise label  usually describes the accumulation of 5, and often more, medications. Polypharmacy  in advancing age frequently results in drug therapy problems related to  interactions, drug toxicity, falls with injury, delirium, and nonadherence. Polypharmacy is associated with resulting increased hospitalizations and higher  costs of care for individuals and health care systems. To reduce polypharmacy, we  delineate a systematic, consultative approach to identify highest-risk medications  and drug-therapy problems. We address strategic reductions (deprescribing) of  medications in palliative care, long-term care, and ambulatory older adults. Best  practices for reducing opioids, benzodiazepines, and other high-risk medications  include education about risk and agreement by patients and their families,  advocates, and care teams. Addressing deprescribing should be within the framework  of patients' health status as their care and goals transition from longevity to a  plan of maintaining alertness, comfort, and satisfaction of quality of life. A team  approach to address polypharmacy and avoidance of high-risk therapy is optimal  within long-term care. Patients with terminal illnesses or those moving toward a  comfort-care emphasis benefit from medication adjustments that are recognized  beneficially within each patient's care goals. In caring for older adults, the  acknowledgement that complicated regimens and high-risk medications requires a care  plan to reduce or prevent medication-related problems and costs that are associated  with polypharmacy.<p /> <p>Language: en</p>",
language="en",
issn="0025-6196",
doi="10.1016/j.mayocp.2020.06.012",
url="http://dx.doi.org/10.1016/j.mayocp.2020.06.012"
}