Title : Limiting factors in implementing pharmacovigilance principles in the elderly
Abstract:
The overarching aim of pharmacovigilance is to ensure the safe and effective usage of medication across the population and optimise medicines through holistic considerations. However, within the heterogeneous elderly population, a number of unique factors are at play, limiting the ability of clinicians to fulfill this aim. A matured physiology influencing the response and effects of drugs, increased polypharmacy enabling drug-drug interactions and greater consumption of concurrent herbal medicines predispose patients to harmful drug events. This increasingly multi-morbid subpopulation requires complex pharmaceutical regimens to reduce inappropriate prescribing and medicine non-adherence leading to sub-optimal therapy. Drugs are often developed, optimized and delivered with the average person in mind, leaving the prerequisites of an elderly population commonly neglected despite a disproportionate consumption of medication by this age group. Furthermore, restrictive practices in clinical trials commonly exclude elderly patients creating disparities from expected findings within a real-world setting. These issues create an environment where elderly patients are at heightened risk of ADEs and clinicians are forced to make significant decisions from limited information. The projected growth of the elderly demographic paints an upward spiral for polypharmacy, suboptimal therapy and increased mortality as a result of ADEs. Thus, we must not only recognize current limiting factors but also create actionable Initiatives concerning multiple parties in order to achieve safer and more effective therapies for our future elderly population.
