Prescribing in the elderly

Abstract

Medicines can prolong life, relieve suffering and maintain dignity, but they can also harm. In South Africa, where primary care is often the first point of call for the elderly, the responsibility to prescribe wisely is a clinical imperative. However, prescribing for this demographic can be challenging. Significant heterogeneity with altered and variable pharmacokinetics and pharmacodynamics make this population uniquely vulnerable, while polypharmacy magnifies the risks of adverse drug reactions, interactions and prescribing cascades. These can be mitigated by intentional evidence-based prescribing, regular review, judicious deprescribing, shared decision-making and multidisciplinary collaboration.