Polypharmacy and multi-morbidity – allies or rivals in geriatric medicine.



Year of publication 2017
Type Article in Proceedings
Conference WONCA Asia Pacific Regional Conference 2017, Pattaya (Thailand), 1st-4th November 2017. Abstractbook
Keywords Polypharmacy -multi-morbidity – allies or rivals in geriatric medicine.
Description Polypharmacy is common in the elderly, especially in the late age (over 75 years). Usually it is closely related to the geriatric multi-morbidity. The general practitioner (GP) is de facto a 1st-line geriatrician in common practice, so we consider issues such as the relationship between multimorbidity and polypharmacy today as a very crucial issue, especially with regard to the current demographic prognosis of the global population aging. In the elderly population there are common permanent decrease of functional capacity, gradual emergence of various diseases leading to the wider multi-morbidity. There is a lack of evidences for a specific treatment of multi-morbid seniors because they are usually excluded from major clinical trials. Multi-morbid elderly patients who are treated in accordance with guidelines typically use large amounts of medicaments. Polypharmacy often justified and effective in the old age depends primarily on co-existing multi-morbidity. Although the individual diseases are quite correctly indicated and treated according to EBM (evidence-based medicine), quite often possible impending pharmacological interactions recede into the background. While physicians often must make difficult trade-offs between the guidelines on one hand and complicated multiple morbidity on the other, they try to avoid polypharmacy (? 5 drugs), especially excessive polypharmacy (? 10 drugs). Reduction of excessive polypharmacy is a benefit for the patient's health, it improves the treatment adherence and reduces the cost of medication. The aim of geriatric medicine is to optimize residual functions despite the decline in total functional capacity with increasing multi-morbidity and used polypharmacy.

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