| アブストラクト | There are numerous definitions of polypharmacy to describe the use of many medications among older adults, but there is a need to clarify if they are purposive and meaningful. By means of a systematic review, we identified definitions of polypharmacy used in multimorbid older adults (>/=65 years). We evaluated if the definitions align among the domains of research, clinical practice, and public health and appraised whether concepts of polypharmacy are based on strong foundations. More than 46 definitions of polypharmacy were retrieved from 348 publications (research: n = 243; clinical practice: n = 88; public health: n = 17). Several thresholds based on the number of medications were mentioned. The majority of the publications (n = 202, 58%) used a minimal threshold of five medications. Heterogeneous qualitative definitions were identified, mostly stating that polypharmacy is "more drugs than needed". There was no significant divergence between domains as to the type of definitions used, although qualitative definitions were more common in clinical practice. Nearly half (n = 156, 47%) of the publications provided no justification for the polypharmacy definition used. The wide variety of definitions for polypharmacy precludes comparisons, appropriate identification and management of polypharmacy in multimorbid older adults. Standardized definitions would allow more coherent judgments regarding the individual and collective stakes of polypharmacy. |
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| 投稿者 | Sirois, Caroline; Domingues, Nelia Sofia; Laroche, Marie-Laure; Zongo, Arsene; Lunghi, Carlotta; Guenette, Line; Kroger, Edeltraut; Emond, Valerie |
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| 組織名 | Department of Social and Preventive Medicine, Faculty of Medicine, Laval;University, Quebec, QC G1V 0A6, Canada. caroline.sirois@fmed.ulaval.ca.;Centre of Excellence on Aging of Quebec, CIUSSS-CN, Quebec, QC G1S 4L8, Canada.;caroline.sirois@fmed.ulaval.ca.;Centre de Recherche sur les Soins et les Services de Premiere Ligne de;L'Universite Laval, Quebec, QC G1J 0A4, Canada. caroline.sirois@fmed.ulaval.ca.;Institut National de Sante Publique du Quebec, Quebec, QC G1V 5B3, Canada.;L'Universite Laval, Quebec, QC G1J 0A4, Canada.;Service de Pharmacologie, Toxicologie et Pharmacovigilance, Centre Regional de;Pharmacovigilance, de Pharmacoepidemiologie et D'information sur les Medicaments,;Centre Hospitalier Universitaire de Limoges, 87042 Limoges, France.;INSEM 1248, Faculte de Medecine, Universite de Limoges, 87032 Limoges, France.;Faculty of Pharmacy, Universite Laval, Quebec, QC G1V 0A6, Canada.;Sante des Populations et Pratiques Optimales en Sante, Centre de Recherche du CHU;de Quebec, Quebec, QC G1S 4L8, Canada.;Department of Nursing, University of Quebec at Rimouski, Levis, QC G6V 0A6,;Canada.;Centre de recherche du CISSS de Chaudiere-Appalaches, Levis, QC G6V 3Z1, Canada. |
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