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Letter to the Editor| Volume 11, ISSUE 4, P296-297, May 2010

A Conversation: Polypharmacy in the Nursing Home

      Dr Morley's offer to have a conversation about polypharmacy is timely, but there is little in his editorial to rebut.
      • Morley J.E.
      Polypharmacy in the nursing home.
      Although aggressive management of higher risk elderly patients can be defended, polypharmacy is clearly a burden to the entire nursing home system.
      • Gurwitz J.H.
      Polypharmacy: A new paradigm for quality drug therapy in the elderly.
      Medication errors are largely a numbers game, and we should reduce numbers of med passes when we can.
      • Tangalos E.D.
      • Zarowitz B.J.
      Combination drug therapy.
      Preventive treatments are often of marginal benefit to elderly patients at low risk, but withdrawing potentially helpful treatment on the basis of number of medications is not a logical solution to polypharmacy. Innovative methods to replace medications with nonpharmacologic interventions or reducing med passes seem much more logical.
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      References

        • Morley J.E.
        Polypharmacy in the nursing home.
        J Am Med Dir Assoc. 2009; 10: 289-291
        • Gurwitz J.H.
        Polypharmacy: A new paradigm for quality drug therapy in the elderly.
        Arch Intern Med. 2004; 164: 1957-1958
        • Tangalos E.D.
        • Zarowitz B.J.
        Combination drug therapy.
        J Am Med Dir Assoc. 2005; 8: 406-409
        • Cohn J.N.
        The fallacy of the mean.
        J Card Fail. 2001; 7: 103-104
        • Stevenson L.
        Challenges for the basis of practice in heart failure.
        Circ Heart Fail. 2008; 1: 81-83
        • Morley J.E.
        Phronesis and the medical director.
        J Am Med Dir Assoc. 2009; 10: 149-152
        • Taleb N.
        The Black Swan: The Impact of the Highly Improbable.
        Random House, New York2007
        • Wharam J.S.
        • Sulmasy D.
        Improving the quality of health care: Who is responsible for what?.
        JAMA. 2009; 301: 215-217
        • Aristotle I.T.
        Nichomachean Ethics.
        Hackett Publishing Company, Indianapolis, IN1999
        • Katz P.
        • Jurgisn K.
        • Intrator O.
        • Mor V.
        Nursing home physician specialists: A response to the workforce crisis in long-term care.
        Ann Intern Med. 2009; 150: 411-413
        • Gladwell M.
        Outliers: The Story of Success.
        Little Brown and Company, New York2008

      Linked Article

      • Polypharmacy in the Nursing Home
        Journal of the American Medical Directors AssociationVol. 10Issue 5
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          “I firmly believe that if the whole materia medica as now used, could be sank to the bottom of the sea, it would be all the better for mankind—and all the worse for fishes”—Oliver Wendell Holmes
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