Questions and Answers
What is the primary purpose of prescription medication for older patients?
To enable them to maintain a quality of life
What is the increased likelihood of frailty for patients taking five or more medications?
One and a half times
What is the increased likelihood of being prescribed an inappropriate medication for frail patients?
Twice
What are the frailty syndromes that medications can cause or contribute to?
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Which of the 5Ms is most relevant to polypharmacy?
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What is a major difficulty associated with polypharmacy?
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What type of research studies are commonly used in the field of polypharmacy?
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What is the purpose of identifying the strength of an association between an illness and a specific medication?
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What is the primary consequence of polypharmacy on patients' quality of life?
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What is the primary challenge in establishing a causal relationship between medication use and patient outcomes?
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What is the primary focus of the 'Matters most' aspect of the 5Ms?
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What is the primary advantage of observational studies in the field of polypharmacy?
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What is the primary consequence of polypharmacy on the caregiver or family member?
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What is the primary challenge in deprescribing for patients with multi-complexity?
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What is the primary goal of the 'Mind' aspect of the 5Ms?
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What is the primary advantage of the 5Ms framework in the context of polypharmacy?
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Study Notes
The Impact of Polypharmacy
- Older patients taking five or more medications are 1.5 times more likely to become frail within a 3-year period than those who take less than five medications.
- Frail patients are twice as likely to be prescribed an inappropriate medication than patients who are not experiencing frailty.
- Polypharmacy can negatively impact patients and their families or carers.
- Frailty syndromes include falls, cognitive impairment, incontinence, immobility, and susceptibility to side-effects of medications.
- Medications can cause or contribute to all of these syndromes.
The 5Ms
- The 5Ms principles and actions are relevant to deprescribing.
- Mind: Mentation, dementia, delirium, depression.
- Mobility: Impaired gait and balance, fall injury prevention.
- Medications: Polypharmacy, deprescribing, adverse medication effects, medication burden.
- Multi-complexity: Multi-morbidity, complex bio-psychosocial situations.
- Matters most: Each patient has meaningful health outcome goals and care preferences.
Polypharmacy Research
- Determining cause and effect is difficult in polypharmacy research.
- Authors rely on identifying the strength of an association between an illness and a specific medication.
- Observational studies (e.g., cohorts) are typically used in polypharmacy research.
- Experimental studies are often unfeasible in this field.
- Observational research has identified risk factors for older persons taking multiple medications.
The Impact of Polypharmacy
- Older patients taking five or more medications are 1.5 times more likely to become frail within a 3-year period than those who take less than five medications.
- Frail patients are twice as likely to be prescribed an inappropriate medication than patients who are not experiencing frailty.
- Polypharmacy can negatively impact patients and their families or carers.
- Frailty syndromes include falls, cognitive impairment, incontinence, immobility, and susceptibility to side-effects of medications.
- Medications can cause or contribute to all of these syndromes.
The 5Ms
- The 5Ms principles and actions are relevant to deprescribing.
- Mind: Mentation, dementia, delirium, depression.
- Mobility: Impaired gait and balance, fall injury prevention.
- Medications: Polypharmacy, deprescribing, adverse medication effects, medication burden.
- Multi-complexity: Multi-morbidity, complex bio-psychosocial situations.
- Matters most: Each patient has meaningful health outcome goals and care preferences.
Polypharmacy Research
- Determining cause and effect is difficult in polypharmacy research.
- Authors rely on identifying the strength of an association between an illness and a specific medication.
- Observational studies (e.g., cohorts) are typically used in polypharmacy research.
- Experimental studies are often unfeasible in this field.
- Observational research has identified risk factors for older persons taking multiple medications.
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