Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens

Paula A Rochon, MD; Mirko Petrovic, MD; Antonio Cherubini, MD; Graziano Onder, MD; Denis O'Mahony, MD; Shelley A Sternberg, MD; Nathan M Stall, MD; Jerry H Gurwitz, MD

The Lancet. Healthy Longevity (May 2021)

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens

Paula A Rochon, MD,
Mirko Petrovic, MD,
Antonio Cherubini, MD,
Graziano Onder, MD,
Denis O'Mahony, MD,
Shelley A Sternberg, MD,
Nathan M Stall, MD,
Jerry H Gurwitz, MD

Affiliations

Paula A Rochon, MD: Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; Correspondence to: Dr Paula A Rochon, Women's College Research Institute, Women's College Hospital, Toronto, ON, M5S 1B2, Canada
Mirko Petrovic, MD: Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
Antonio Cherubini, MD: Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento at IRCCS INRCA, Ancona, Italy
Graziano Onder, MD: Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
Denis O'Mahony, MD: Department of Medicine (Geriatrics), School of Medicine, University College Cork, Cork, Ireland
Shelley A Sternberg, MD: Maccabi Healthcare Services, Modiin, Israel
Nathan M Stall, MD: Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
Jerry H Gurwitz, MD: Division of Geriatric Medicine and Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA

Journal volume & issue: Vol. 2, no. 5
pp. e290 – e300

Abstract

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Summary: Polypharmacy is very common in older adults and increases the risk of inappropriate and unsafe prescribing for older adults. Older adults, particularly women (who make up the majority of this age group), are at the greatest risk for drug-related harm. Therefore, optimising drug prescribing for older people is very important. Identifying potentially inappropriate medications and opportunities for judicious deprescribing processes are intrinsically linked, complementary, and essential for optimising medication safety. This Review focuses on optimising prescribing for older adults by reducing doses or stopping drugs that are potentially harmful or that are no longer needed. We explore how sex (biological) and gender (sociocultural) factors are important considerations in safe drug prescribing. We conclude by providing a practical approach to optimising medication safety that clinicians can routinely apply to the care of their older patients, highlighting how sex and gender considerations inform medication decision making.

Published in The Lancet. Healthy Longevity

ISSN: 2666-7568 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Special situations and conditions: Geriatrics
Website: https://www.thelancet.com/journals/lanhl/home

About the journal