Polypharmacy and Rational Drug Use In The Elderly
Özet
This text examines the critical public health issue of polypharmacy and inappropriate drug use among the elderly. Polypharmacy, commonly defined as the concurrent use of four or five or more medications, is highly prevalent in older populations due to multiple chronic comorbidities. The frequency of multiple drug use increases with age and reaches its peak within hospitals and nursing homes. This problem is directly linked to increased morbidity, mortality, and healthcare costs, contributing substantially to drug side effects, cognitive decline, malnutrition, and a 2.6-fold increase in the risk of falls. Aging-related pharmacokinetic and pharmacodynamic alterations significantly affect drug metabolism, leading to decreased renal clearance, lower drug tolerance, and enhanced sensitivity to adverse effects. Key risk factors include chronological age, prescription cascades, lack of pharmacological information, and unmodified clinical guidelines for complex cases. To optimize rational drug use, clinicians are encouraged to simplify regimens and leverage scientific evidence-based screening tools such as the Beers criteria, STOPP/START, FORTA, and the Turkish Inappropriate Medication Use in the Elderly (TIME) criteria.
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