the reduced drug clearance
Peer replies
1-Alberto :
Polypharmacy is an area of concern for many patients, especially the elderly. Elderly patients are at a greater risk for adverse drug reactions (ADRs) because of the reduced drug clearance associated with aging and because of metabolic changes (Boris, Cafiero & Smith, 2014). Some risk factors associated with polypharmacy are potential of drug-drug interactions because it is further increased by use of multiple drugs. Another risk factor is hip fractures, associated with adverse drug reactions and losing balance or fainting (Boris, Cafiero & Smith, 2014). Polypharmacy may sometimes lead to “prescribing cascades.”4 Prescribing cascade is said when signs and symptoms (multiple and nonspecific) of an ADR is misinterpreted as a disease and a new treatment/drug therapy is further added to the earlier prescribed treatment to treat the condition (Piere & Farrell, 2012).
In my practice working with the elderly population, to reduce the incidence of polypharmacy medication, patients are evaluated on a monthly basis. Additionally, a single drug is be prescribed instead of multiple drugs for the treatment of a single condition, if possible. Another strategy we use is staring medication with the lower drug dosage and slowly increasing as indicated.
A strategy that seems to be effective, according to research, is prescribe drugs that can be given once or twice a day instead of prescribing drugs that require to be taken three times a day (Thomas, Liao, & McCliar, 2016). The reasoning behind this is to lower the risk of forgetting to take the medication or taking the medication together with other drugs. Another strategy that can be employed is that if the drug taken has no therapeutic beneficial effect or clinical indication it should be eliminated. Unessential drugs should be identified and eliminated prescribed by different health care providers for the same condition/disease (Thomas, Liao, & McCliar, 2016).
