References
Conducting a medication review in older adults
Abstract
Once prescribers have initiated medication regimens, there can be a reluctance to review and discontinue them. Over the past two decades in the UK, the percentage of individuals aged 65 and above on polypharmacy (five or more medications) has risen from 12–49% (Gao et al, 2018). Medication can harm as well as heal, and the need for medication reviews grows as our population ages. This article is one of a series, written by a consultant nurse and a pharmacist, and aims to help readers further develop their skills in medication management.
Older people are more likely to be prescribed medication than younger people; however, unfortunately medication is not always prescribed appropriately, and age-related changes increase a person's vulnerability to adverse effects. According to the World Health Organization (WHO, 2022):
‘Rational use of medicines requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community.’
Irrational use of medicines is a major problem worldwide. The WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. The over-use, under-use or misuse of medicines results in wastage of scarce resources and widespread health hazards.
Older adults (people aged 65 or over) and those ethnic minority and low-income communities are under-represented in clinical trials. This means that prescribers have limited information about the efficacy of a drug and any side effects in these groups (Fisher et al, 2022).
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