Turkish Journal of Geriatrics 2022 , Vol 25, Issue 1
CONTROVERSIAL ISSUES RELATED TO DRUG TREATMENT IN OLDER ADULTS
F. Yeşim GÖKÇE KUTSAL1
1 Hacettepe University Research Center of Geriatric Sciences- GEBAM, Ankara, Turkey DOI : 10.31086/tjgeri.2022.257 Drug therapy in older adults continues to pose problems and cause controversy with its different aspects. Polypharmacy and inappropriate medication, appears to be the major problem worldwide in terms of both geriatric health and healthcare. Also increases the risk of geriatric syndrome and affects the morbidity/mortality rates negatively. A definition for inappropriate medication is "any drug in which the risks outweigh the benefits or where these do not align with goals of care", since it encompasses both ineffective or unnecessary treatment and those treatments with high risk. A range of assessment tools have been developed to identify and measure inappropriate prescribing. The most commonly recommended criteria for the use of drugs in older adults are the Beers criteria by American Geriatrics Society. The "Screening Tool of Older People Prescriptions (STOPP)" and the "Screening Tool to Alert doctors to Right Treatment (START)" are other frequently recommended screening approaches. It seems suitable also to establish consideration of deprescribing within the continuum of treatment recommendations in clinical guidelines. Deprescribing is defined as "the planned, supervised process of medication discontinuation, addressing unnecessary polypharmacy which continues to be a problem among older adults". Evidence-based deprescribing guidelines could be a useful component in the effort to address the global problem of polypharmacy. However, it is important to keep in mind that it is essential to consider the ethical and legal dimensions in all these approaches. Another issue is the herbal products and since the general knowledge about food/beverage-drug interactions are found to be poor, there seems a need to enhance the community awareness of these interactions especially for older adults. Keywords : Geriatrics; Drug Therapy; Inappropriate Prescribing; Polypharmacy; Deprescriptions