Polypharmacy in the Elderly

Polypharmacy is the regular use of multiple medications and is often seen in older adults and individuals with multiple comorbidities. The commonly accepted definition of polypharmacy is the use of five or more medications by any individual. As patients become more multimorbid, the use of medication therapy increases and in turn raises the risk of polypharmacy. Polypharmacy is often associated with adverse outcomes, including increased mortality, falls, drug interactions, drug reactions, increased length of stay in the hospital, and increased readmission to the hospital after discharge. Patients over the age of 65 are often not included or well represented in drug trials, which can make medical decision-making challenging for evaluation of risk versus benefit in this patient population. There are several important factors to take note of when evaluating patients with polypharmacy.