Polypharmacy

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"As older patients move through time, often from physician to physician, they are at increasing risk of accumulating layer upon layer of drug therapy, as a reef accumulates layer upon layer of coral."
-- Jerry Avorn, MD

Polypharmacy

Holmes, Holly M. Polypharmacy. Theme issue of Clinics in Geriatric Medicine, May 2012, Volume 28, Number 2.
Link to table of contents.

Dwyer LL, Han B, Woodwell DA, et al. Polypharmacy in nursing home residents in the United States. Am J Geriatr Pharmacother. 2010;8:63–72.
Link to abstract.

Sergi G, Rui MD, Sarti S, et al. Polypharmacy in the elderly. Drugs Aging 2011; 28 (7): 509-518.
Link to abstract.

Steinman MA, Hanlon JT. Managing medications in clinically complex elders: “There’s got to be a happy medium.” JAMA. 2010;304(14):1592-1601.
Link to abstract.

Hayes BD, Klein-Schwartz W, Barrueto F. Polypharmacy and the geriatric patient. Clin Geriatr Med 2007;23:371–390.
Link to abstract.

Steinman MA, Landefeld CS, Rosenthal GE, et al. Polypharmacy and prescribing quality in older people. J Am Geriatr Soc 2006;54:1516–1523.
Link to abstract.

Polypharmacy: Guidance for Prescribing in Frail Adults - NHS Highland, Polypharmacy Action Group, November 2011.
Link to full text.

Deprescribing

Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults. Arch Intern Med. 2010;170(18):1648-1654.
Link to abstract.

Ostini R, Jackson C, Hegney D, et al. How is medication prescribing ceased? A systematic review. Med Care 2011;49:24–36.
Link to abstract.

Parsons C, Hughes CM, Passmore AP, et al. Withholding, discontinuing and withdrawing medications in dementia patients at the end of life. Drugs Aging 2010; 27 (6): 435-449.
Link to abstract.

Iyer S, Naganathan V, McLachlan AJ, et al. Medication withdrawal trials in people aged 65 years and older – a systematic review. Drugs Aging 2008; 25 (12): 1021-1031.
Link to abstract.

Bain KT, Holmes HM, Beers MH, et al. Discontinuing medications: a novel approach for revising the prescribing stage of the medication use process. J Am Geriatr Soc 2008;56:1946–1952.
Link to abstract.

Beer C, Loh P, Peng YG, et al. A pilot randomized controlled trial of deprescribing. Ther Adv in Drug Safe. 2011;2(2):37-43.
Link to abstract.

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