The emergence of new effective and safe medicines (drugs) for the prevention and treatment of many diseases and their complications contributes to an increase in life expectancy and, thereby, demographic aging of the world’s population as a whole. But, like any drugs, new drugs can cause adverse reactions (AD). In this regard, literature monitoring and pharmacovigilance are of particular importance. Literature review and pharmacovigilance can accelerate the development of various tactics to reduce the risk of ADR, if necessary.

It should be noted that in patients of the older age group, the goal of pharmacotherapy is shifted towards controlling the symptoms of diseases, improving the quality of life and minimizing the use of drugs. This is especially important in the aspect of polypharmacy — the simultaneous administration of several types of drugs to a patient, the consequences of which are an increased risk of developing AD, an increase in morbidity and mortality, as well as the risk of hospitalization or prolongation.

Another reason for the development of complications (consequences) of pharmacotherapy is drug-drug interactions — a change in the efficacy and safety of one drug against the background of simultaneous or sequential use with another drug. And here, literature monitoring and pharmacovigilance are loyal assistants of both physicians and national health systems. Literature review, pharmacovigilance for reporting about HP are used especially often in the Nordic countries.

 So, according to Walckiers D., with the appointment of 5 or less drugs, the risk of developing HP does not exceed 5%, and when 6 or more drugs are used, it increases to 25%. Other authors provide information indicating that from 17 to 23% of drug combinations prescribed by doctors are potentially dangerous and in a third of cases can cause death.

Purpose of the work: systematization and analysis of data on non-pharmacological methods of treatment to improve the safety of pharmacotherapy and prevent polypharmacy in elderly patients by informing healthcare professionals about non-pharmacological methods for correcting significant geriatric problems. To reduce the risk of complications due to polypharmacy in patients of the older age group, a number of approaches can be recommended, including:

— training doctors, patients, relatives and persons caring for elderly and senile people, the rational use of medicines;

— optimization of medicinal prescriptions by a clinical pharmacologist;

— the use of auxiliary computer systems in the selection of drugs;

— personalization of care and therapy, taking into account the polymorbidity and functional status of patients, for example, according to the presence and severity of senile asthenia, impaired liver and kidney function, phenotypic, genetic and metabolic profiles, etc.;

— cancellation of prescription (deprescribing) of medicinal products — dose reduction or drug cancellation after consultation with a doctor, followed by monitoring the patient’s condition;

— the use of individually selected non-drug methods of treatment and prevention of pathologies (diet, exercise, cognitive training, vision correction through the selection of glasses, hearing with hearing aids, etc.).

The last point seems to be especially relevant, since in the case of some nosologies characteristic of geriatric patients, non-pharmacological methods of treatment come to the fore. Literature monitoring and pharmacovigilance showed that the use of non-pharmacological approaches can significantly increase the safety of drug therapy, reduce the risks of developing ADR, improve the prognosis and quality of life of the patient, and also effectively combat polypharmacy in elderly patients. The pharmacovigilance of the Nordic countries has documented relevant literature reviews.

*А. П. Переверзев, О. Н. Ткачева, Ю. В. Котовская, Ю. С. Онучина, Е. Н. Дудинская, А. В. Наумов
*Безопасность и риск фармакотерапии. 2018.6(4).pdf