Polypharmacy and older people - the GP perspective

TY - JOUR

T1 - Polypharmacy and older people - the GP perspective

AU - Vass, M

AU - Hendriksen, C

N1 - Keywords: Aged; Aged, 80 and over; Family Practice; Germany; Health Services for the Aged; Humans; Physician's Practice Patterns; Physician-Patient Relations; Polypharmacy; Practice Guidelines as Topic; Primary Prevention; Risk Assessment; Risk Factors

PY - 2005

Y1 - 2005

N2 - It is well known that problems with compliance rise exponentially when more that 4 drugs are prescribed. The rising use of prescription medicine forces the GP to balance the benefit of evidence group-based appropriate drug use against the problems arising when medication is given to older people and to consider different approaches when evaluating evidence of risk and benefit for the individual. Old people are facing a considerable risk of adverse drug reactions and recent initiatives, including the Continuous Medical Educational Efforts Programme, address issues of inappropriate prescribing practices. The authors recommend and present tools enabling the GP to focus on 'the core prescribing situation'. The logistics to optimise medication including compliance, the use of modern IT and better collaboration and communication between primary and secondary care are in focus. Since medication review is recommended at every encounter, and time consuming comprehensive follow-up will be demanded, 'polypharmacy consultations' surely will be built into GP contracts in the future. The authors state that a number of pharmacological regimens for older people are outperformed by non-pharmacological treatment alternatives involving competent individualised counselling and public provision of easy (transportation) possibilities for joining centres offering staff and equipment for physical and social activity (including basal aids for hearing and sight).

AB - It is well known that problems with compliance rise exponentially when more that 4 drugs are prescribed. The rising use of prescription medicine forces the GP to balance the benefit of evidence group-based appropriate drug use against the problems arising when medication is given to older people and to consider different approaches when evaluating evidence of risk and benefit for the individual. Old people are facing a considerable risk of adverse drug reactions and recent initiatives, including the Continuous Medical Educational Efforts Programme, address issues of inappropriate prescribing practices. The authors recommend and present tools enabling the GP to focus on 'the core prescribing situation'. The logistics to optimise medication including compliance, the use of modern IT and better collaboration and communication between primary and secondary care are in focus. Since medication review is recommended at every encounter, and time consuming comprehensive follow-up will be demanded, 'polypharmacy consultations' surely will be built into GP contracts in the future. The authors state that a number of pharmacological regimens for older people are outperformed by non-pharmacological treatment alternatives involving competent individualised counselling and public provision of easy (transportation) possibilities for joining centres offering staff and equipment for physical and social activity (including basal aids for hearing and sight).

U2 - 10.1007/s00391-005-1104-1

DO - 10.1007/s00391-005-1104-1

M3 - Journal article

C2 - 16189730

SN - 0948-6704

VL - 38 Suppl 1

SP - I14-7

JO - Zeitschrift fuer Gerontologie und Geriatrie

JF - Zeitschrift fuer Gerontologie und Geriatrie

ER -