Introduction à la rationalisation de la pharmacothérapie chez le sujet âgé

Elderly have often multiple comorbidities and take regularly more than five medications. Polypharmacy and inappropriate pharmacotherapy develop insidiously and require a medication review using explicit (based on criteria) or implicit (based on assessor's judgment) tools. Explicit measures are based on expert consensus and literature, but poorly flexible. On the contrary, implicit measures are specific to a given patient; however, they necessitate access to patient's information and depend upon clinician's knowledge and experience. Tools currently available need to be improved and assessed; yet they represent the first step toward rationalization.