RT Book, Section A1 Sengstock, David A1 Zimmerman, Jonathan A2 Williams, Brie A. A2 Chang, Anna A2 Ahalt, Cyrus A2 Chen, Helen A2 Conant, Rebecca A2 Landefeld, C. Seth A2 Ritchie, Christine A2 Yukawa, Michi SR Print(0) ID 1100069326 T1 Addressing Polypharmacy & Improving Medication Adherence in Older Adults T2 Current Diagnosis & Treatment: Geriatrics, 2e YR 2014 FD 2014 PB McGraw-Hill Education PP New York, NY SN 978-0-07-179208-0 LK accessmedicine.mhmedical.com/content.aspx?aid=1100069326 RD 2024/10/07 AB Older adults are the largest consumers of prescription drugs. A large survey reported that more than one-half of patients 57–85 years old used at least 5 prescription medications, nonprescription medications, and nutritional supplements. Predictably, the number of medications steadily increased with the age of the patient. This survey also reported that 1 in 20 of these patients risked a major drug–drug interaction; half of these interactions included a nonprescription agent. Research demonstrates that polypharmacy is an independent risk factor for adverse outcomes, including hospitalization, nursing home placement, hypoglycemia, falls and fractures, pneumonia, and malnutrition, and death. Older adults are also generally less tolerant to the effects of a medication. This intolerance can manifest as an exaggerated effect of a medication or even a different effect as compared to younger patients, and is described at length in Chapter 9, “Principles of Prescribing for Older Adults.”