How can side effects related to medications be prevented?
The elderly population is highly vulnerable to medication-related problems manifesting in adverse events including falls, depression, confusion, constipation, and hip fractures. Studies suggest a 6% to 30% incidence of adverse drug events (ADEs) in the elderly. These ADEs are undesirable, harmful, and in many cases preventable by following some basic principles when prescribing medications to the elderly.
Polypharmacy remains a significant risk factor for adverse drug events, especially in the elderly population due to the presence of multiple comorbidities. For this reason, it is advised that the number of providers prescribing medication is limited. In addition, when starting a new medication, it is best to start only one at a time and use the least invasive route of delivery and to start at a low dose that is slowly titrated to effect. When titrating medications and/or changing medication, adequate time intervals should be given in order to prevent adverse drug events or overdosage. Knowing the half-life of a drug can allow a provider to confidently make adjustments while minimizing the risk of harm.
Prior to starting a patient on a new medication, it is essential to determine the quality of the pain the patient is suffering from (i.e., nociceptive vs. neuropathic vs. mixed) in order to choose a medication best suited for that type of pain.