Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review.
Maria Cristina Soares Rodrigues, Cesar de Oliveira
PMID 27598380WHAT IT FOUND
Polypharmacy in older adults frequently causes drug interactions and adverse reactions, linked to specific drug classes and non-adherence.
Multidisciplinary care involving nurses, pharmacists, and physicians improves safety through monitoring and education.
Key findings
01Drug interactions and adverse reactions are frequent end results of polypharmacy, associated with specific predictors like comorbidities, cognitive impairment, and use of high-risk drugs such as warfarin, benzodiazepines, and antidepressants.
02Older adults achieve better medication outcomes when care is managed by a multidisciplinary team including physicians, clinical pharmacists, and nurses.
03Early detection of clinically important interactions by healthcare professionals is vital for monitoring adverse events across the continuum of care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Publication bias due to language (English, Spanish, Portuguese) and database restrictions. Selection bias because unpublished research was not included. Lack of methodological assessment and risk of bias analysis for the reviewed studies due to heterogeneity. Inconsistent definitions of polypharmacy across the included studies.
Declared interests
Supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.
The easy way to misread this
Do not assume this review provides a single definitive threshold for polypharmacy risk. The included studies used varying definitions (3 to 10+ medications), so the risk is context-dependent and influenced by specific drug classes and patient factors rather than just the number of pills.