Document Type : Review Articles
Authors
1
Ksa, Ministry of Health, health Center ALFAQRAH
2
Ksa, Ministry of Health, Al Kharj Maternity and Children Hospital
3
Ksa, Ministry of Health, King Fahd PHC
4
Ksa, Ministry of Health, King Salman Hospital
5
Ksa, Ministry of Health, Primary health Center Al-aziziah2
6
Ksa, Ministry of Health, Al-Salihiya PHC
7
Ksa, Ministry of Health, Abu Arish General Hospital
8
Ksa, Ministry of Health, Al-Bujadiyah General Hospital
9
Ksa, Ministry of Health, Shared community health services
10
Ksa, Ministry of Health, King Abdullah Hospital Bisha
11
Ksa, Ministry of Health, Al-Dawadmi General Hospital
12
Ksa, Ministry of Health,in Riyadh
13
Ksa, Ministry of Health, AlMazrou PHC
14
Ksa, Ministry of Health, supply chains /Jazan Health Cluster
Abstract
Background
Polypharmacy, characterized by the concurrent use of multiple medications, has become a cornerstone of geriatric healthcare management. This phenomenon reflects the growing prevalence of chronic illnesses and increasing life expectancy among aging populations worldwide. However, the benefits of polypharmacy in managing complex comorbidities are often overshadowed by significant concerns regarding drug efficacy, safety, and the heightened risk of adverse drug events (ADEs). These challenges are compounded by age-related physiological changes, including reduced renal and hepatic clearance, decreased protein binding, and altered drug metabolism. These factors not only increase the vulnerability of older adults to medication-related harms but also impose a considerable burden on healthcare systems through increased hospitalizations, extended inpatient stays, and higher healthcare costs. Consequently, balancing the therapeutic advantages of polypharmacy with its risks represents a pressing challenge for healthcare providers, patients, and policymakers.
Aim
The aim of this paper is to provide a comprehensive examination of the impact of polypharmacy on drug efficacy and safety in geriatric populations. By addressing its prevalence, associated adverse outcomes, and evidence-based strategies to optimize medication management, the paper seeks to contribute to the development of practical solutions for healthcare providers and decision-makers. Ultimately, it aims to support the design of policies and practices that prioritize patient safety while ensuring the effective management of chronic conditions in older adults.
Methods
This study conducted asystematic review of existing literature from 2020 to 2024, including randomized controlled trials,observational studies, meta-analyses, and qualitative research focused on polypharmacy in geriatric populations. The analysis explored adverse outcomes associated with polypharmacy, such as ADEs, drug-drug interactions, and reduced therapeutic efficacy, and evaluated the success of intervention strategies including deprescribing protocols, interdisciplinary medication reviews, and technological innovations such as clinical decision support systems (CDSS). The methodological approach emphasized the inclusion of diverse healthcare settings, such as hospitals, long-term care facilities, and community-based practices, to capture the multifaceted nature of polypharmacy management.
Results
The findings reveal a pervasive association between polypharmacy and increased healthcare risks among geriatric populations. Adverse drug events, including falls, delirium, gastrointestinal complications, and cardiovascular toxicity, were consistently linked to polypharmacy, particularly in patients prescribed anticholinergics, sedatives, and anticoagulants. Drug-drug interactions emerged as a leading cause of therapeutic inefficacy and toxicity, highlighting the need for improved prescribing practices. Interventions such as deprescribing and interdisciplinary medication reviews demonstrated significant efficacy in reducing medication burdens and enhancing patient outcomes. Despite these advances, barriers to effective implementation, such as resistance to change among patients and providers and the lack of standardized clinical guidelines, remain significant challenges.
Conclusion
Polypharmacy embodies a dual-edged dynamic in geriatric care, offering essential solutions for managing chronic diseases while introducing substantial risks to patient safety. Mitigating these risks requires a multifaceted approach that integrates evidence-based practices, interdisciplinary collaboration,patient-centered care, and technological advancements. Future research must focus on refining these strategies to overcome implementation barriers and create sustainable solutions.Collaborative efforts among healthcare providers, patients, caregivers, and policymakers are essential to addressing the systemic challenges of polypharmacy and enhancing the overall quality of care for aging populations.
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