Author Affiliations: Division of Geriatrics, University of California, San Francisco, and the San Francisco VA Medical Center, San Francisco, California (Dr Steinman); Division of Geriatric Medicine, Department of Medicine, Department of Epidemiology, and Department of Pharmacy and Therapeutics, University of Pittsburgh; Geriatric Research Education and Clinical Center, and Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System (Dr Hanlon), Pittsburgh, Pennsylvania.
Multiple medication use is common in older adults and may ameliorate symptoms, improve and extend quality of life, and occasionally cure disease. Unfortunately, multiple medication use is also a major risk factor for prescribing and adherence problems, adverse drug events, and other adverse health outcomes. Using the case of an older patient taking multiple medications, this article summarizes the evidence-based literature about improving medication use and withdrawing specific drugs and drug classes. It also describes a systematic approach for how health professionals can assess and improve medication regimens to benefit patients and their caregivers and families.
Steinman MA, Hanlon JT. Managing Medications in Clinically Complex Elders“There's Got to Be a Happy Medium”. JAMA. 2010;304(14):1592–1601. doi:10.1001/jama.2010.1482