6. Geriatric Pharmacotherapy

  1. Brent C. Williams MD, MPH1,
  2. Preeti N. Malani MD, MSJ2 and
  3. David H. Wesorick MD3
  1. Gabe Solomon,
  2. Macgregor A. Montaño and
  3. Paul C. Walker

Published Online: 26 JUL 2013

DOI: 10.1002/9781118674963.ch6

Hospitalists' Guide to the Care of Older Patients

Hospitalists' Guide to the Care of Older Patients

How to Cite

Solomon, G., Montaño, M. A. and Walker, P. C. (2013) Geriatric Pharmacotherapy, in Hospitalists' Guide to the Care of Older Patients (eds B. C. Williams, P. N. Malani and D. H. Wesorick), John Wiley & Sons, Inc., Hoboken, NJ, USA. doi: 10.1002/9781118674963.ch6

Editor Information

  1. 1

    Divisions of General Medicine and Geriatrics and Palliative Care, Department of Internal Medicine, University of Michigan

  2. 2

    Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Geriatric Research Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System

  3. 3

    Division of General Medicine, Hospitalist Program, Department of Internal Medicine, University of Michigan

Publication History

  1. Published Online: 26 JUL 2013
  2. Published Print: 23 AUG 2013

ISBN Information

Print ISBN: 9781118127926

Online ISBN: 9781118674963

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Keywords:

  • adverse drug events (ADEs);
  • adverse drug reactions (ADRs);
  • geriatric pharmacotherapy;
  • medication adherence;
  • older adults;
  • polypharmacy;
  • transitional care issues

Summary

A fundamental barrier to safe and effective medication use in the geriatric population is the absence of a strong evidence base to guide clinical decision‐making. This chapter provides a framework for hospitalists to optimize medication use in older adults in the acute care setting. Overcoming challenges in prescribing for older adults, identifying inappropriate medications, and avoiding adverse drug reactions (ADRs) are reviewed with an emphasis on commonly used, high‐risk medications in the hospitalist's armamentarium. The chapter addresses transitional care issues since older patients are particularly vulnerable to fragmented care when moving between care settings. Patients at greatest risk of polypharmacy include older patients taking five or more drugs, those with multiple physicians and pharmacies, those with impairments in vision or dexterity, and individuals recently hospitalized. A meta‐analysis found that the incidence of serious and fatal adverse drug events (ADEs) in hospitalized patients is extremely high.