International Journal of Clinical Case Reports, 2025, Vol.15, No.4, 159-170 http://medscipublisher.com/index.php/ijccr 162 3.2 The impact of age-related physiological changes on drug metabolism The bodies of elderly patients with multiple diseases change with age, which has a significant impact on the processing of drugs in the body. The decline of kidney and liver functions, changes in body composition, and variations in gastrointestinal absorption capacity may all affect the absorption, distribution, transformation and effect of drugs after entering the body, making people more prone to drug side effects (Lv et al., 2022; Swarbrick et al., 2025). Therefore, it is necessary to adjust the dosage of the medication and closely monitor the patient's condition, especially when the patient is taking multiple medications simultaneously. Physical frailiness is common among elderly people with multiple diseases, which can complicate drug metabolism and make people more vulnerable to drug-related harm (Swarbrick et al., 2025). Low body mass index, low activity level and multiple chronic diseases can all lead to physical weakness, which is associated with a higher possibility of adverse conditions such as deep vein thrombosis and pressure ulcers during hospitalization (Lv et al., 2022). This emphasizes the importance of adopting personalized drug treatment methods for such people. 3.3 Information fragmentation and drug coordination issues in multidisciplinary nursing For elderly patients with multiple diseases, the discontinuity of the care process is a major problem, as they often have to see different doctors and nurses in different places. This may lead to poor communication, incomplete transmission of medical information, inconsistent medication management, and increase the risk of complications caused by concurrent use of multiple drugs and drug adjustment (Gao et al., 2024; Christensen et al., 2025). Incomplete care processes and the lack of standard assessment tools have exacerbated these coordination challenges. Some attempts have been made to improve medication coordination, such as establishing comprehensive nursing approaches and grading assessment tools to identify patients with complex needs and promote cooperation among different departments. However, these methods are still rather limited at present. There is an urgent need for a proven team collaboration model now to ensure the sharing of medical information and the coordination of medication arrangements for elderly patients with multiple diseases (Gao et al., 2024; Christensen et al., 2025). 4 Potential Risks of Combined Medication 4.1 The incidence of adverse drug reactions is high among the elderly Due to the changing physical conditions with age and the extensive use of multiple medications, the elderly are particularly prone to adverse drug reactions (ADRs). Studies have shown that the more medication one takes, the higher the risk of hospitalization and death, and the relationship between the two is obvious (Maher et al., 2014; Khezrian et al., 2020). For instance, nearly half of the elderly who take multiple medications will be hospitalized for treatment. With each additional medication taken, the risk of death from various causes will significantly increase (Leelakanok et al., 2017; Chang et al., 2020). Patients who are physically weak or have cognitive impairments (such as dementia) have a higher risk of adverse drug reactions. When these people use multiple drugs, the probabilities of visiting the emergency room, accidental hospitalization and death are all relatively high (Veronese et al., 2017; Kristensen et al., 2018; Mueller et al., 2018). These findings suggest that drugs for this group of people should be carefully examined and monitored to minimize preventable harm. 4.2 Drug-drug interactions lead to the emergence of new therapeutic problems The concurrent use of multiple drugs increases the likelihood of adverse drug interactions (DDI), which may cause new health problems or worsen existing conditions. Among elderly people with complex conditions such as heart disease and cancer, the incidence of severe underlying DDI is quite high, with more than 75% of patients having experienced at least one severe drug interaction (Sheikh-Taha and Asmar, 2021; Mohamed et al., 2023; Oliveira et al., 2024). Common problematic combinations include drugs that act on the brain, drugs that may cause prolonged QT intervals in the heart, and adverse combinations of anticholinergic drugs with other high-risk drugs (Sheikh-Taha and Asmar, 2021; Oliveira et al., 2024).
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