The multi medication is generally defined as taking more than four concomitant medications. However, it can also be defined as the prescribing or use more drugs than those actually needed to care for a patient. The latter definition adds a qualitative dimension, that of the adequacy of the prescription, including the notion that only one unnecessary medication can cause side effects that could have been avoided.
The multi medication in the elderly is a well known phenomenon and many studies have been conducted on this topic. Studies in the United States on patients living in institutions reported that they simultaneously take on average six to eight different medicines.
[...] It also shows that for patients taking less medication than the average at the entrance ( 2.9 1.6 there is a significant increase in the number of drugs prescribed to the output ( 3.8 Consequences of multi medication The consequences of this multi medication are essentially three types. First, the multi medication can lead to problems of non-compliance. It exists in all age groups and does not appear to increase with advance in age. However, it was shown that the higher the number of drugs increases, less adherence to treatment is good. [...]
[...] With the advance in age, some diseases occur more frequently and are against- indications for use of certain medications. This includes all anticholinergic drugs in the presence of a glaucoma, prostatic hypertrophy, an weakening intellectual or other impairment of the central nervous system. Is an individual dosage is necessary? Cockroft formula for estimating renal function clinically and calculate the necessary adaptation dose in renal insufficiency, especially with regard to drugs eliminated by the kidneys and that the therapeutic range is narrow (digoxin, lithium , theophylline). [...]
[...] Referring to a survey in the Northeast C. Zuniga Prescription medication in elderly patients at the Hospital de Gériatrie of Geneva (unpublished data) RB Stewart, GJ Caranasos. Medication compliance in the elderly. Med Clin North Am 1989; 73: 1551- Col Fanale JE, Kronholm P. The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Arch Intern Med 1990; 150: 841- Carbonin Pahor Bernabei Sgadari A. Is age an independent risk factor of adverse drug reactions in hospitalized medical patients. J [...]
[...] It is interesting to consider the various pathologies of the patient in order of priority. The involvement of the patient himself is paramount, not to put before a dichotomous choice between two types of treatment, but only through an open interview, the patient may become known in its entirety, and that the prescribing doctor can then make proposals consistent therapeutic. Thus, a patient allergenic whose life is centered on intellectual activity might choose deliberately to avoid taking opiates, despite their higher efficiency, if they interfere with his ability to concentrate. [...]
[...] The credits can reduce the cost of drugs prescribed to be charged to the patient or that of health insurance. Generics are often the ailments commonly treated as outpatients. Is there a benefit / cost optimal? A prescription drug cost is only justified if it is essential for the treatment of the patient and there is no alternative of equal efficacy cheaper. Conclusion The presence of multiple pathologies in an elderly patient often leads to an increase in drug prescriptions and puts the patient at high risk. [...]
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