Polypharmacy and Deprescribing for Older Adults

Abstract

Polypharmacy, which refers to using multiple medications by an individual, is becoming increasingly common in the aging population. Although it can be beneficial in treating complex medical conditions, it also carries inherent risks, such as adverse drug reactions, drug interactions, cognitive impairment, and increased healthcare costs. With increased medication use, it is essential to consider the risks and benefits of each prescribed medication. Evidence-based guidelines, such as the Beers Criteria and the Screening Tool of Older Persons’ Prescriptions criteria, can help healthcare providers reduce the risks of polypharmacy. Deprescribing, the process of reducing or stopping medication use that is no longer necessary or potentially harmful, is becoming increasingly important in managing polypharmacy. The 5Rs Framework and the Medication Appropriateness Index are two examples of clinical practice guidelines for deprescribing. Communication and collaboration between healthcare providers and patients, gradual tapering of medication, and involvement of patients and caregivers in decision-making are important considerations for deprescribing in primary care. This article provides an overview of the prevalence and negative consequences of polypharmacy, evidence-based guidelines for reducing polypharmacy, clinical practice guidelines for deprescribing, and considerations for deprescribing in primary care.