Polypharmacy in older adults at home: what it is and what to do about it-implications for home healthcare and hospice, part 2.

Polypharmacy-the use of more medications than are clinically indicated-is a problem that affects many older adults. Adults aged 65 years and older make up approximately 13% of the population, but they consume nearly one third of all prescriptions dispensed. Older adults are more prone to adverse drug reactions and drug-drug interactions because of physiological changes and multiple comorbidities. It can be difficult to address the problem because there are many contributing factors, including multiple prescribers and specialists, the use of multiple pharmacies, and gaps in communication. The initial step is to avoid the problem. However, when this does not work, it must be identified and then treated by carefully changing medication regimens to improve the quality of care to patients. The home healthcare nurse has an essential role in this process, which will be reviewed in this article. Some of the barriers that may be encountered and examples of communication with providers are included.