Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens

Paula A Rochon¹, Mirko Petrovic², Antonio Cherubini³, Graziano Onder⁴, Denis O'Mahony⁵, Shelley A Sternberg⁶, Nathan M Stall⁷, Jerry H Gurwitz⁸

Affiliations

¹ Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada. Electronic address: paula.rochon@wchospital.ca.
² Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
³ Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento at IRCCS INRCA, Ancona, Italy.
⁴ Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy.
⁵ Department of Medicine (Geriatrics), School of Medicine, University College Cork, Cork, Ireland.
⁶ Maccabi Healthcare Services, Modiin, Israel.
⁷ Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
⁸ Division of Geriatric Medicine and Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA.

PMID: 36098136
DOI: 10.1016/S2666-7568(21)00054-4

Free article

Review

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens

Paula A Rochon et al. Lancet Healthy Longev. 2021 May.

Free article

. 2021 May;2(5):e290-e300.

doi: 10.1016/S2666-7568(21)00054-4.

Authors

Paula A Rochon¹, Mirko Petrovic², Antonio Cherubini³, Graziano Onder⁴, Denis O'Mahony⁵, Shelley A Sternberg⁶, Nathan M Stall⁷, Jerry H Gurwitz⁸

Affiliations

¹ Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada. Electronic address: paula.rochon@wchospital.ca.
² Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
³ Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento at IRCCS INRCA, Ancona, Italy.
⁴ Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy.
⁵ Department of Medicine (Geriatrics), School of Medicine, University College Cork, Cork, Ireland.
⁶ Maccabi Healthcare Services, Modiin, Israel.
⁷ Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
⁸ Division of Geriatric Medicine and Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA.

PMID: 36098136
DOI: 10.1016/S2666-7568(21)00054-4

Abstract

Polypharmacy is very common in older adults and increases the risk of inappropriate and unsafe prescribing for older adults. Older adults, particularly women (who make up the majority of this age group), are at the greatest risk for drug-related harm. Therefore, optimising drug prescribing for older people is very important. Identifying potentially inappropriate medications and opportunities for judicious deprescribing processes are intrinsically linked, complementary, and essential for optimising medication safety. This Review focuses on optimising prescribing for older adults by reducing doses or stopping drugs that are potentially harmful or that are no longer needed. We explore how sex (biological) and gender (sociocultural) factors are important considerations in safe drug prescribing. We conclude by providing a practical approach to optimising medication safety that clinicians can routinely apply to the care of their older patients, highlighting how sex and gender considerations inform medication decision making.

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Conflict of interest statement

Declaration of interests PAR, NMS, GO, SAS, and MP declare no competing interests. DO has a patent (11757950.8-1952) issued from the European Patent Office on Aug 30, 2011, called A Prescription Decision Support System (based on STOPP/START criteria). JHG reports personal fees from United Healthcare, outside of the submitted work. AC reports personal fees from Bristol Myers Squibb for participating in an advisory board on direct anticoagulants and personal fees from MSD for a lecture on aging, outside of the submitted work.

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Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens

Affiliations

Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources