Appropriate Use of Medicine and Polypharmacy in Older Patients

Abstract

In Japan, the population aged 65 years and older exceeds 28% of the total population. Since the birth rate is also declining, aging of the population is likely to continue. According to a patient survey conducted by the Ministry of Health, Labour and Welfare in 2014, the number of outpatients aged ≥65 years was higher by approximately 1.8 million since the previous survey in 2011. Drug therapy for the elderly is, thus, a matter of rapidly growing importance. The older generation has poorer physiological functions than younger adults. Therefore they are more likely to experience variable efficacy of drugs administered. The incidence of adverse effects is known higher in elderly people, and multidrug regimens are often unavoidable, especially when patients have more than one disease. In elderly patients, chronic lifestyle-related diseases are usually associated with geriatric syndrome. Given these circumstances, the potential area to be covered by pharmacists is very broad, and they should be involved in drug treatment of elderly people from hospital to home. We therefore propose the establishment of a new scientific field of geriatric pharmacology. We will consider novel approaches to geriatric pharmacotherapy from the viewpoints of basic science and clinical practice, deliberating the role that pharmacists should play in the provision of polypharmacy in older patients.