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  Vol. 164 No. 18, October 11, 2004 TABLE OF CONTENTS
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Polypharmacy

A New Paradigm for Quality Drug Therapy in the Elderly?

Arch Intern Med. 2004;164:1957-1959.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

As older patients move through time, often from physician to physician, they are at increasing risk of accumulating layer upon layer of drug therapy, as a reef accumulates layer upon layer of coral.Jerry Avorn, MD

There once was a time when polypharmacy was considered to be a bad thing in older patients.1 It is well known that use of larger numbers of drugs is associated with an increased likelihood of inappropriate prescribing2 and adverse drug events.3 Drug-induced symptoms can also produce prescribing cascades that develop when an adverse effect is misinterpreted as a new medical problem, leading to the prescription of additional drugs.4 Yet, the number of medications prescribed to elderly patients and the complexity of their drug regimens have continued to increase over time.5-6 Therapeutic regimens that include the use of 2 or more different medications to treat a single condition are increasingly promoted for the optimal . . . [Full Text of this Article]

THE LACK OF HIGH-QUALITY EVIDENCE TO GUIDE PRESCRIBING


THE ADOPTION OF NEW SYSTEMS OF CARE

COSTS AS A BARRIER

CONCLUSIONS
Jerry H. Gurwitz, MD



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