Medication management in vulnerable elders requires careful review of evidence due to high prescription burden and altered pharmacokinetics.
May inform cautious prescribing in vulnerable elders; leaves open optimal deprescribing strategies for prospective trials.
scription drugs; quality indicators; quality measurement Medications play a critical role in maintaining thehealth of vulnerable elders (VEs), who often contend with a great burden of acute and chronic illness. Older pa-tients disproportionately use prescription drugs, with se-niors filling an average of 20 prescriptions annually,1 and aging can be associated with decreased metabolism and excretion of prescription drugs and their metabolites, plac-ing elderly patients at greater risk of side effects and com-plicating appropriate dosing. Additionally, patients, caregivers, and even physicians often mistake medication side effects for the onset of new illnesses or ‘‘aging’ ’ itself. The underrepresentation of elderly patients in clinical trials and the resulting deficiencies of useful data to guide practice create additional challenges for prescribers. A careful re-view of existing evidence can inform clinical practice and
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Shrank et al. (2007) studied this question.
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