A study was done to investigate the association between different combined statuses of frailty and polypharmacy on risks of adverse outcomes. The subjects were aged 65-100 years old and were identified from an Insurance Research Database in Taiwan. Frailty was categorized into fit, mild, moderate, and severe frailty based on the multimorbidity frailty index. The use of 5-9 and over 10 chronic medications was considered “polypharmacy” or “excessive polypharmacy.”
Compared with fit without polypharmacy, severe frailty with excess polypharmacy was associated with increased risks of adverse outcomes, particularly unplanned hospitalization, however the combined effects varied in distinct groups. Within each frailty category, the dose-response association between polypharmacy and adverse outcomes was limited to fit and mildly frail people.
The study concluded that both frailty and polypharmacy modified the risks of mortality and hospital admissions in older people, but the combined effects varied in distinct groups. It is important to optimize the care of older people by capturing the combined changes related to frailty and polypharmacy. We do a decent job with the pharmacy piece; experience has taught us that medications and the elderly don’t mix well, plus surveyors are reviewing medications more closely as well. At the end of the day, do the right thing for your residents, and get rid of medications that aren’t necessary; quality of life is important, and medications can and often do interfere with that!
Stay well, mask up, and stay tuned!