Polypharmacy and Frailty Scores in Geriatric Patients

Abstract

This Doctor of Nursing Practice (DNP) project aimed to explore the concept and definition of polypharmacy by examining the number of medications taken and the frailty scores of this study’s sample population. According to Jandu et al. (2024) and Alqahtani (2023), polypharmacy is described as the simultaneous use of multiple medications that pose a significant concern for older adults due to its association with adverse events, including falls, hospitalizations, and even death. Other researchers have placed a numeric value in the definition of polypharmacy, but the most commonly found in the literature review included taking “five plus medications in one day, six plus medicines in one day, seven plus in one day, and ten plus in one day” (Alqahtani, 2023; Fried et al., 2014; Donnell & Ibrahim, 2022). Mortazavi et al. (2016), Reeve et al. (2015), and Tsang et al. (2024), determined that a more substantial definition of polypharmacy could lead to improved medication strategies based on age group, reduction of adverse events, and improved frailty scores. A more substantial definition of polypharmacy could contribute to improved healthcare outcomes (Alqahtani, 2023; Carollo et al., 2024; Chang et al., 2020; Mach et al., 2021). The goal of this DNP research study was to determine if a correlation existed between polypharmacy and frailty.

Frailty is a geriatric clinical syndrome characterized by greater vulnerability (Alqahtani, 2023; Church et al., 2020; Mach et al., 2021). Several studies have researched polypharmacy and frailty scores and have concluded that taking five plus medications daily is associated with increased frailty (Ekram et al., 2022; Van Dam et al., 2022; Veronese et al., 2017). Such studies have also concluded that the association of frailty scores with clinical outcomes have highlighted its usefulness in geriatric persons and have indicated that those with higher frailty scores were sicker and more likely to be hospitalized (Church et al., 2020; Kaeppeli et al., 2020; Mendiratta et al., 2023; Rockwood et al., 2005). This DNP study hypothesized that taking more than five medications increased study participants’ Clinical Frailty Score (CFS) to a score of five or higher. There is a gap in the literature in identifying if the number of medications elderly individuals took correlated with their frailty score.

This DNP study included a retrospective chart review of 50 medical records. The sample population included geriatric individuals aged 65 or older who received a voluntary, community in-home, routine healthcare visit. Among the 50 charts chosen randomly, three did not meet the age criteria of 65-plus and were excluded from this study. The demographic data collected included ages, numbers, and class of medications, as well as frailty scores of the sample population. The primary objective was to identify a threshold for the number of medications indicative of polypharmacy for each age group and the number of daily medications that potentially affected frailty scores. While several studies have evaluated how those taking larger numbers of medications experienced higher frailty scores, there is a gap in the literature regarding the specific number of medications among different age cohorts that correlates with higher Clinical Frailty Scale scores (Alqahtani, 2022; Cheng et al., 2022; Jandu et al., 2024; Mach et al., 2021; O’Donnell & Ibrahim, 2022; Veronese et al., 2017).

Disciplines

Gerontology | Nursing

Subject Area

Nursing; Gerontology; Aging; Health care management

Department

Nursing (NUR)

First Advisor

Fairbanks, Clarisse

Second Advisor

Cherubini, Debra

Third Advisor

Keating, Sharon

Date of Award

2025

Document Type

Dissertation

Degree Name

D.N.P.

Link to Full Text

Share

COinS