Polypharmacy is a leading cause of morbidity in the older adult population. Advanced practice nurses (APRNs) can improve medication safety in their older adult patients by doing all the following EXCEPT:

Polypharmacy in older adults increases the risk of adverse drug events, drug-drug interactions, falls, cognitive impairment, and hospitalizations. Safe prescribing requires regular medication review, reconciliation, and evaluation of appropriateness based on current clinical needs. Advanced practice nurses play a key role in minimizing unnecessary medications and optimizing therapeutic regimens. The goal is to improve safety while avoiding overprescribing, especially of high-risk medications. Rationale: A. Assessing medications for drug-drug interactions is essential in older adults because multiple concurrent medications increase the risk of harmful pharmacologic interactions. These interactions can alter drug metabolism, increase toxicity, or reduce therapeutic effectiveness. Regular review helps prevent adverse drug events and ensures safe pharmacotherapy. B. Performing a thorough medication history and reconciliation ensures that all prescribed, over-the-counter, and herbal medications are accurately documented. This process helps identify duplications, omissions, and potentially inappropriate medications. It is a critical step in preventing errors during transitions of care and ongoing treatment. C. Assessing for non-adherence, underuse, and inappropriate use of medications helps identify barriers to effective treatment in older adults. Patients may skip doses, take incorrect amounts, or continue unnecessary medications due to misunderstanding or cognitive decline. Addressing these issues improves therapeutic outcomes and reduces medication-related harm. D. Routinely prescribing opioids for pain is inappropriate in older adults due to increased risks of sedation, respiratory depression, falls, constipation, and dependence. Opioids should only be used when necessary, at the lowest effective dose, and for the shortest duration possible. Non-opioid and non-pharmacologic pain management strategies are preferred as first-line approaches in most cases.