Table 2.

General considerations for managing polypharmacy in older adults

• Throughout medication history

○ “Brown Bag” asking patient to bring in all prescription, OTC, and herbal medications

▪ “Teach-back” method, patient shows how taking medication

○ Determine patient adherence to medication and barriers if not adherent

▪ Is the patient forgetting to take?

▪ Is the pill difficult to take?

▪ Is the pill costly?

▪ Does the patient believe that the drug is not needed?

○ Where possible use the same pharmacy

• Indications for current medications

○ Determine if medication is on Beers List or Medication Appropriateness Index

○ Is the dosage correct?

• Review drug–drug interactions

• Determine the therapeutic ratio

○ Start low and go slow for titration up

• Good communication with other healthcare providers (physicians and caregivers)

Abbreviation: OTC, over-the-counter.