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Polypharmacy among inpatients aged 70 years or older in Australia

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Research has confirmed a significant association between polypharmacy — defined here as five or more regular prescription medications1 — and adverse outcomes among older people living in the community. The associations of polypharmacy in older people admitted to hospital have been less extensively explored. Older inpatients are a vulnerable group, at high risk of prolonged hospital stays, institutionalisation and death.2 Several studies have reported a high prevalence of potentially inappropriate medications among older inpatients (ranging from 20%3 to 60%4) and, while potentially inappropriate medications have been linked to adverse drug reactions,5 the most significant predictor of adverse drug reactions among inpatients is the number of medications prescribed.6

Medications can, of course, prolong life and prevent serious morbid events in older people. People aged 80 years and over are at highest risk of cardiovascular events, and the absolute benefits of primary and secondary prevention may be greatest in this group.7 Medications can also improve quality of life through symptom control and maintenance of function. Individualisation of therapy should underpin prescribing, weighing up the potential benefits…