Medication Management for Older Adults
Polypharmacy risks, deprescribing, the annual review and tools that prevent dangerous mistakes.
8 min read
Polypharmacy — typically defined as five or more chronic medications — is the norm after 70 and is independently associated with falls, hospitalization and cognitive impairment.
An annual medication review with the prescribing clinician or a pharmacist should ask three questions of every drug: is the indication still present, is the dose still appropriate, and is there a safer alternative?
Deprescribing is a clinical skill. The Beers Criteria and STOPP/START tools identify medications that are usually inappropriate in older adults — anticholinergics, long-acting benzodiazepines and certain NSAIDs lead the list.
Practical tools reduce dispensing errors: a single pharmacy, pharmacy-packaged blister packs, a written medication list carried to every appointment, and a weekly pill organizer filled by the same person each week.
Symptoms commonly attributed to aging — fatigue, dizziness, confusion, falls — are often medication side effects. Pattern-match before accepting them as inevitable.