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Why is medication review important in the elderly? A Comprehensive Guide

4 min read

According to the Lown Institute, nearly 1.2 million older Americans were hospitalized between 2011 and 2015 due to the side effects of one or more drugs. Regular medication review is a proactive and critical step in preventing these issues, ensuring a safer and healthier aging process for seniors.

Quick Summary

Regular medication reviews are essential for elderly individuals to reduce the risks associated with polypharmacy, including dangerous drug interactions, adverse side effects, and improper dosing. These comprehensive evaluations by healthcare professionals ensure a safe and effective medication regimen, ultimately improving quality of life.

Key Points

  • Reduce Risks: Regular reviews protect against polypharmacy, harmful interactions, and side effects common in older adults.

  • Improve Safety: Age-related body changes affect how medications work; reviews ensure dosages remain safe and effective.

  • Simplify Regimens: Deprescribing unnecessary medications reduces pill burden, making daily management easier and safer.

  • Empowerment: Patients and caregivers gain a clearer understanding of treatment plans, leading to better adherence and health outcomes.

  • Prevent Complications: Avoiding adverse drug events reduces hospitalizations and cognitive issues linked to inappropriate medication use.

  • Save Money: Eliminating duplicate or unnecessary prescriptions can lead to significant cost savings.

In This Article

The Risks of Medications for Older Adults

As people age, their bodies undergo natural physiological changes that can significantly impact how medications are absorbed, metabolized, and eliminated. Reduced kidney and liver function, decreased body water, and increased body fat can alter a drug's effectiveness and increase the risk of side effects. Compounded by the high likelihood of polypharmacy—the use of multiple medications—this creates a dangerous scenario where a regimen that was once safe can become harmful over time. Many older adults also use a combination of prescription drugs, over-the-counter medications, and supplements, further increasing the potential for adverse drug events.

Polypharmacy and its Dangers

Older adults often manage multiple chronic conditions, leading to a complex and ever-changing mix of prescriptions. This common practice of polypharmacy is a major reason why medication review is important in the elderly. The more medications an individual takes, the higher the risk of dangerous drug-drug or drug-disease interactions. These interactions can lead to a host of problems, from mild discomfort to life-threatening events. Issues can include:

  • Adverse Drug Events (ADEs): Unintended and harmful reactions to a medication.
  • Cognitive Impairment: Certain drugs can cause confusion, memory loss, and delirium, sometimes mistaken for dementia.
  • Increased Fall Risk: Medications like sedatives and blood pressure drugs can cause dizziness and unsteadiness.
  • Non-adherence: A complicated regimen with many pills can make it difficult for seniors to take their medications correctly, leading to missed doses or accidental double-dosing.
  • Increased Cost: Taking unnecessary or duplicate medications can lead to significant financial strain.

The Critical Benefits of a Medication Review

A medication review is a systematic and comprehensive evaluation of a patient's entire medication list by a healthcare professional, such as a pharmacist or doctor. This process goes beyond a simple refill check and can lead to significant health improvements. The core objective is to optimize a patient's medication use and improve health outcomes.

  • Reduces Adverse Drug Events: By identifying and resolving potential drug interactions, a review significantly lowers the risk of dangerous side effects and ADEs.
  • Optimizes Dosages: As body composition changes with age, the review ensures that dosages are still appropriate and effective, adjusting them to prevent toxicity.
  • Simplifies Regimens (Deprescribing): One of the most powerful outcomes is deprescribing—the process of reducing or stopping unnecessary medications. This simplifies the daily routine and reduces the pill burden.
  • Improves Adherence: By making the medication schedule easier to follow, the patient is more likely to take their medications as prescribed.
  • Empowers Patients: Medication reviews are an opportunity for patients and caregivers to ask questions and better understand their treatment plan, fostering a sense of control over their health.
  • Lowers Healthcare Costs: By removing unnecessary and duplicate medications, reviews can help reduce costs for both the patient and the healthcare system.

The Medication Review Process: What to Expect

Preparing for Your Review

Coming prepared is key to a successful medication review. The 'brown bag' method is a simple yet effective strategy where patients gather all their medications and bring them to the appointment.

  1. Gather all medications: Collect every prescription, over-the-counter drug, vitamin, and supplement. Include the original bottles if possible.
  2. Make a list: Note down the dosage, frequency, and reason for taking each medication. Include any known side effects.
  3. Prepare questions: Write down any concerns, questions, or side effects you've experienced. Don't be afraid to ask for clarification.

Who Conducts the Review?

A medication review can be performed by various healthcare professionals. Often, a pharmacist is best equipped to conduct a Comprehensive Medication Review (CMR), as they have specialized knowledge of pharmacology.

What Happens During the Review?

During the appointment, the healthcare provider will:

  • Review your complete medication list: Checking for potential interactions, duplicates, and inappropriate prescribing.
  • Assess appropriateness: Using guidelines like the Beers criteria to evaluate if a medication is appropriate for older adults.
  • Discuss goals: Aligning your medication regimen with your overall health goals and preferences.
  • Provide education: Explaining the purpose of each medication and how to take it correctly.
  • Formulate a plan: Collaborating with your primary care physician to adjust the medication regimen as needed.

Comparison: Before vs. After Medication Review

Aspect Before Medication Review After Medication Review
Medication List Unorganized, potential for duplicates Streamlined, optimized, fewer unnecessary drugs
Safety Risk High risk of drug interactions, side effects Minimized risk of adverse drug events
Complexity Confusing and complex dosing schedule Simplified, easier-to-follow regimen
Effectiveness Potential for ineffective dosages or conflicts Improved treatment efficacy
Cost Wasted money on unnecessary medications Reduced medication expenses
Patient Empowerment Passive recipient of medications Active participant in healthcare decisions

Conclusion: The Path to Safer Medication Management

For the elderly, medications are a crucial part of managing health, but they come with unique challenges that increase with age and complexity. By actively engaging in regular medication reviews with a healthcare professional, seniors and their caregivers can significantly mitigate these risks. These reviews are a powerful tool for promoting safety, enhancing treatment effectiveness, and improving overall quality of life, transforming a passive process into a proactive partnership for better health.

For more information on the principles of safe medication management in older adults, refer to resources provided by the National Institutes of Health (NIH).

Frequently Asked Questions

Experts recommend a medication review at least once a year, or whenever a new medication is prescribed, there is a change in health status, or an unexplained symptom arises.

A medication review can be conducted by a pharmacist, doctor, or a clinical pharmacist specializing in geriatric care. Pharmacists are often the most accessible specialists for a thorough review.

Bring a complete list of all prescriptions, over-the-counter medications, and supplements, including dosages and frequency. Also, list any side effects or concerns you have experienced.

Polypharmacy is the use of multiple medications, often five or more, by an individual. It is common in the elderly and increases the risk of side effects and dangerous drug interactions.

Yes, a review can help identify medications that may cause or worsen cognitive impairment, such as confusion or memory loss. Adjusting or removing these medications can lead to significant improvements.

Potentially. By identifying unnecessary or duplicate medications, a review can lead to a simplified regimen and lower overall prescription costs.

Yes, a medication review is a dedicated appointment focused solely on evaluating your medication regimen, not just renewing prescriptions. It is a deeper, more specialized assessment.

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.