Managing Polypharmacy in Elderly Patients: Deprescribing for Therapeutic Optimization and Reducing Adverse Effects

Polypharmacy is a common phenomenon in elderly patients, characterized by the simultaneous use of multiple medications. This scenario can lead to significant adverse effects, including drug interactions, toxicity, and adherence issues, which increase the risk of hospitalizations and healthcare costs. Deprescribing and therapeutic optimization are key strategies to address these challenges, improving quality of life and reducing the risks associated with polypharmacy.

Diving Deeper into Deprescribing and Therapeutic Optimization

Deprescribing is a systematic process of reducing or eliminating medications that are no longer necessary or may be harmful. This approach is not only feasible and safe but also provides an opportunity to reevaluate the therapeutic needs of elderly patients. However, implementing deprescribing in daily clinical practice can be complex due to the lack of consensus on best practices and the need for effective tools to measure outcomes.

A consultative and systematic approach is essential to identify high-risk medications and issues related to pharmacotherapy. Education about the risks and collaboration with patients and their families are fundamental for the success of deprescribing. Additionally, involving a multidisciplinary team, including pharmacists and geriatricians, can facilitate the identification of potentially inappropriate medications and the implementation of deprescribing strategies.

Research has shown that deprescribing can be safe and well-tolerated, with potential benefits for mental health, function, and frailty in patients. However, it is crucial to continue investigating to better understand the impact of deprescribing in high-risk populations, such as frail elderly individuals.

Conclusions

Managing polypharmacy in elderly patients requires a careful and personalized approach. Deprescribing and therapeutic optimization are powerful tools to enhance the safety and efficacy of pharmacological treatment in this population. As we move forward, it is essential to integrate these practices into routine care, supported by health policies and ongoing education for healthcare professionals. By doing so, we can significantly improve the quality of life of our elderly patients and reduce the risks associated with polypharmacy.

Referencias

• [1] Polypharmacy and Deprescribing in Older Adults
• [2] Polypharmacy Management in Older Patients
• [3] A systematic review of the evidence for deprescribing interventions among older people living with frailty

Created 13/1/2025