New international principles for medication management in elderly

It’s known that frail older people, who are frequently on complex medication regimes or are prescribed multiple medicines (polypharmacy) due to multifaceted medical conditions (dementia, poor vision, limited dexterity), often experience challenges managing their medications.

Additionally, the medical conditions that frail older people may have, put them at increased risk of harm from medication errors.

To address this concern, new international principles have been developed for medication management in frail older people, to protect them from medication-related harm due to complex regimes or polypharmacy.

Teaming up with researchers from countries with ageing populations, including Finland, France, Italy, Norway and Sweden, researchers from Monash University’s Centre for Medicine Use and Safety (CMUS) and the National Health and Medical Research Council Centre of Research Excellence (CRE) in Frailty and Healthy Ageing  have led the development of new principles for medication management in frail older people.

“These principles represent a positive step towards improving medicines management among our most vulnerable members of society,” says pharmacist and PhD candidate with CMUS and the CRE, Shin Liau.

The principles relate to clinical practice (seven principles), research (six principles) and education (four principles), and include:

  • Ensuring appropriate prescribing and deprescribing;
  • Including more frail older people in clinical trials;
  • Improving health and medication literacy;
  • Facilitating better communication among patients, carers and healthcare teams.

According to CMUS Director and Chief Investigator with the CRE, Professor Simon Bell, frail older people may have a different risk-to benefit ratio from their medicines compared to others.

“Frail older people are often excluded from participating in clinical trials, and so the evidence-base for prescribing in this population is limited,” says Professor Bell.

Medicine safety recently became Australia’s newest national health priority, with health ministers recognising the urgent need to ensure medicines improve the health of older Australians.

The principles have been endorsed by the European Geriatric Medicine Society (EuGMS), International Conference on Frailty and Sarcopenia Research (ICFSR) and Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR).