There is an urgent need to address the growing problem of polypharmacy in the elderly. Elderly patients are often prescribed multiple medications, some of which are high risk or no longer necessary, which increases the risk for adverse drug reactions and health care costs. Reducing polypharmacy should be a priority for clinicians working in nursing homes. Clinicians should consider care goals, disease trajectory, and life expectancy when discontinuing medications. This article discusses the challenges associated with deprescribing, the ethical and clinical uncertainty that can exist in the indefinite use of some medications, and the guidelines available to help clinicians.
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Linda M. Liu, DNP, ANP-BC, GNP-BC, ACHPN, MSc(a), is a geriatric nurse practitioner for UnitedHealthcare Community Plan in Waltham, MA.
Published online: November 01, 2013
In compliance with national ethical guidelines, the author reports no relationships with business or industry that would pose a conflict of interest.
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.