Discontinuation of unnecessary medications in older adults.

OBJECTIVE: Identifying and managing the use of medications that may be discontinued is a daunting task for the health care team, especially for the consultant pharmacist. This article discusses a framework to evaluate the risks and benefits of medications. A case-based approach will be employed to demonstrate the application of evidence-based medicine and the challenges that pharmacists face in attempting to discontinue medications in older adults. DATA SOURCES: Medline and Micromedex were used as resources for primary literature as well as drug information. STUDY SELECTION: Studies were identified based on their relevance to the case to demonstrate the importance of applying emerging literature and evidence-based medicine. DATA EXTRACTION: Guidelines on managing osteoporosis as well as diabetes in older adults were used for this case. DATA SYNTHESIS: A structured framework was applied to demonstrate considerations when tackling challenging medication regimens.
CONCLUSION: Patient-centered, individualized medication regimens need to be developed and updated based on the needs of the patient as well as the wishes of the family and caregivers. This is a dynamic process that benefits from the consultant pharmacist, who understands the complexity of the medications and is essential to addressing the use of unnecessary medications.