D 2017

Polypharmacy and multi-morbidity – allies or rivals in geriatric medicine.

WEBER, Pavel and Hana MELUZÍNOVÁ

Basic information

Original name

Polypharmacy and multi-morbidity – allies or rivals in geriatric medicine.

Name (in English)

Polypharmacy and multi-morbidity – allies or rivals in geriatric medicine.

Authors

WEBER, Pavel and Hana MELUZÍNOVÁ

Edition

1st edition October 2017. Bangkok, Thailand, WONCA Asia Pacific Regional Conference 2017, Pattaya (Thailand), 1st-4th November 2017. Abstractbook, p. 261-628, 2017

Publisher

The Royal College of Family Physicians of Thailand

Other information

Type of outcome

Stať ve sborníku

Confidentiality degree

není předmětem státního či obchodního tajemství

Publication form

electronic version available online

ISBN

978-616-92988-0-9

Keywords in English

Polypharmacy -multi-morbidity – allies or rivals in geriatric medicine.
Změněno: 23/4/2021 16:12, prof. MUDr. Pavel Weber, CSc.

Abstract

In English

Polypharmacy is common in the elderly, especially in the late age (over 75 years). Usually it is closely related to the geriatric multi-morbidity. The general practitioner (GP) is de facto a 1st-line geriatrician in common practice, so we consider issues such as the relationship between multimorbidity and polypharmacy today as a very crucial issue, especially with regard to the current demographic prognosis of the global population aging. In the elderly population there are common permanent decrease of functional capacity, gradual emergence of various diseases leading to the wider multi-morbidity. There is a lack of evidences for a specific treatment of multi-morbid seniors because they are usually excluded from major clinical trials. Multi-morbid elderly patients who are treated in accordance with guidelines typically use large amounts of medicaments. Polypharmacy often justified and effective in the old age depends primarily on co-existing multi-morbidity. Although the individual diseases are quite correctly indicated and treated according to EBM (evidence-based medicine), quite often possible impending pharmacological interactions recede into the background. While physicians often must make difficult trade-offs between the guidelines on one hand and complicated multiple morbidity on the other, they try to avoid polypharmacy (≥ 5 drugs), especially excessive polypharmacy (≥ 10 drugs). Reduction of excessive polypharmacy is a benefit for the patient's health, it improves the treatment adherence and reduces the cost of medication. The aim of geriatric medicine is to optimize residual functions despite the decline in total functional capacity with increasing multi-morbidity and used polypharmacy.