Medicines and older people: Polypharmacy, adherence and safety

Abstract

Managing medicines is particularly complex for older people with diabetes as well as for family and health professional (HP) carers. Polypharmacy is common and often necessary because of pathophysiological changes associated with diabetes and older age. These changes affect prescribing decisions as well as methods used to administer medicines and to monitor medicine use. Beliefs and attitudes of people with diabetes and HPs about medicines influence their medicine preferences, behaviours and safety. Medicine errors and adverse events (AEs) are common reasons for admission to hospital and also occur in hospital. Insulin is the second most common medicine responsible for most errors and AEs after warfarin. Many older people with diabetes are on both these medicines. The purpose of this paper is to provide an overview of medicines error and AEs, discuss compliance/adherence and suggest some strategies to improve medicine safety in older people with diabetes.