Medication management in the elderly

Barriers to effective medication management among older adults include cognitive impairment, poor vision, and financial burden. Polypharmacy, poor communication, drug-drug interactions, and pharmacokinetic changes with age also contribute to medication problems and nonadherence, and can lead to hospitalizations in 25% of persons age 80 and older. For all of its benefits, the electronic medical record has the potential to reproduce and reinforce inaccuracies. Steps to improving medication management can include using combination drug therapies to simplify schedules, assembling medication teams (some with pharmacists), and reconciling medications across practice sites. Important guidelines are available for successful management of hypertension, lipids, diabetes, respiratory disorders, and thrombotic disorders in patients who may require five or more medications. Health care providers must be mindful that the fewer and more effective the therapies, the safer it will be for patients.