TY - CHAP M1 - Book, Section TI - Principles of Prescribing & Adherence A1 - Steinman, Michael A. A1 - Holmes, Holly M. A2 - Walter, Louise C. A2 - Chang, Anna A2 - Chen, Pei A2 - Harper, G. Michael A2 - Rivera, Josette A2 - Conant, Rebecca A2 - Lo, Daphne A2 - Yukawa, Michi PY - 2021 T2 - Current Diagnosis & Treatment Geriatrics, 3e AB - On the surface, prescribing for older adults is similar to prescribing for younger adults, requiring understanding of drug indications, dosing, potential adverse reactions, and drug-drug interactions. However, prescribing for older adults is complicated by a variety of factors. Physiologic changes as patients get older result in alterations in drug metabolism and susceptibility to adverse events. The presence of multiple chronic conditions and multiple medications leads to potentially complex drug-drug and drug-disease interactions, as well as the need to balance multiple competing recommendations. Changes in cognitive function, manual dexterity, and social supports complicate adherence to medications, and heterogeneous goals of care require special attention. Because clinical trials that inform many practice guidelines are often conducted in younger patients, there can be ambiguity about the extent to which these evidence-based recommendations apply to older adults. Thus, mastering prescribing for older patients requires expertise not only in technical elements of drug use, but also in synthesizing evidence and biomedical and psychosocial factors into a coordinated plan of care that meets each individual’s unique needs. More details about extrapolating the evidence from clinical research to older patients can be found in Chapter 24, “Applying Evidence-Based Care to Older Persons.” SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1180014562 ER -