Approach to medication reviews in older adults

Abstract

The terms medication review and medication reconciliation refer to two different activities and should not be used interchangeably. Medication review is the process of evaluating current medication treatment to manage the risk and optimize the outcomes of medication treatment by detecting, solving, and preventing medication- related problems. Medication reconciliation is the process of obtaining and documenting a complete and accurate list of current patient medications and comparing this list with medication orders at each point of care transition to identify and rectify any discrepancies. Medication review is especially valuable for older adults who tend to take more medications, have more comorbid illnesses, and consequently suffer more adverse drug reactions. ARMOR is an acronym for A ssess, R eview, M inimize, O ptimize, R eassess and represents an example mnemonic for a structured process used to conduct a medication review. It is important to note that intentional nonadherence is common. The Medication Appropriateness Index (MAI) is a tool that can facilitate the analysis of patient’s medication profile. Engaging patients in their medication review and possible deprescribing process will dramatically increase the chance of success in decreasing polypharmacy, stopping inappropriate medications, and lowering the incidence of adverse events such as falls.