Tips for proactive pharmacovigilance in the elderly

1. Know the full medication history of the patient (including OTC medications and nutritional supplements) and search for allergy antecedents.

2. Prioritize clinical objectives and set reasonable therapeutic targets in accordance with patient’s goal(s). Explain therapies and encourage adherence.

3. Check validity of drugs indications and search for underprescribing. Consider phamacologic and non-pharmacologic alternatives. Initiate medicine at low dose and one by one if possible. If a drug is stopped, communicate your choice with other healthcare professionals.

4. Check drugs dosages against renal function. Check drug-drug interactions, drug-disease interactions and drug-food interactions. Use biological monitoring.

5. Search for adverse drug reactions (ADR): new symptoms or worsening of a pre-existing condition should be considered as an ADR. Evaluate treatment efficacy.

Adapted from Veauvy D. [Introduction to rationalization of pharmacotherapy in the elderly]. NPG Neurologie – Psychiatrie – Gériatrie. 2011;11(61):41-45. Abstract.