Komorbiditeler ve Polifarmasi

Osman Tüfekci

doi:10.37609/akya.4084

Yazarlar

Osman Tüfekci

https://orcid.org/0000-0001-5140-3377

DOI: https://doi.org/10.37609/akya.4084.c6677

Özet

Referanslar

Masnoon N, Shakib S, Kalisch-Ellett L, et al. What is poly¬pharmacy? A systematic review of definitions. BMC Geriat¬rics. 2017 Oct 10;17(1):230. doi: 10.1186/s12877-017-0621-2. PMID: 29017448; PMCID: PMC5635569.

Sakar T, Aydınoğlu F. Yaşlılarda Polifarmasi. Akgül H, Şahna E, SelamoğluZ (Eds.). İçinde: Sağlık Bilimleri Alanında Araş¬tırmalar ve Değerlendirmeler II. Ankara Gece kitaplığı 2024. p. 7-36.

WHO.World Health Organization. 13-12-2025 tarihinde Medication safety in polypharmacy: technical report. World Health Organization, 2019.WHO/UHC/SDS/2019.11. adre¬sinden ulaşılmıştır

Levy HB. Polypharmacy Reduction Strategies: Tips on In¬corporating American Geriatrics Society Beers and Scre¬ening Tool of Older People’s Prescriptions Criteria. Clinics in Geriatric Medicine .2017;33(2):177-187. doi:10.1016/j. cger.2017.01.007

Bonanno EG, Figueiredo T, Mimoso IF, et al. Polypharmacy Prevalence Among Older Adults Based on theSurvey of He¬alth, Ageing and Retirement in Europe: An Update. Journal of Clinica lMedicine. 2025 Feb 17;14(4):1330. doi: 10.3390/ jcm14041330.

Khezrian M, McNeil CJ, Murray AD, MyintPK. An over¬view of prevalence, determinants and health outcomes of polypharmacy. Therapeutic Advances in Drug Safety. 2020; 11: 2042098620933741. Published 2020 Jun 12. doi:10.1177/2042098620933741

Licher S, Kieboom BCT, Visser LE, et al. Epidemiology of pol¬ypharmacy in thegeneral population: 27-year prospective co¬hort study. Journal of theAmerican Medical Directors Associa¬tion. 2020;21(8):1177-1179. doi:10.1016/j.jamda.2020.03.014

Yıldırım AB, Kılınç AY. Yaşlı hastalarda polifarmasi ve ilaç etkileşimi. Türk Kardiyoloji Derneği Arşivi. 2017;45(5):17-21. doi:10.5543/tkda.2017.92770

Varghese D, Ishida C, Haseer Koya H. Polypharmacy. Treasu¬re Island (FL): Stat Pearls Publishing; 2024.

15 Kurt M, Akdeniz M, Kavukcu E. Assessment of comorbidity and use of prescription and nonprescription drugs in patients above 65 years at tending family medicine out patient clinics. Gerontology & Geriatric Medicine.2019;5:2333721419874274. Published 2019 Sep 6. doi:10.1177/2333721419874274

Özaydın NF. İleri yaşlılarda uygunsuz ilaç kullanım sıklığı. Sü¬rekli Tıp Eğitimi Dergisi. 2025; 34(3):166-174 DOI: 10.17942/ sted.1529976

WHO (1972) Psychogeriatric, report of a WHO Scientific Group, Technical Reports Series 507, Geneva. Cited in Davi¬se AM. Epidemiology 185; 14(1):9-21. 10-12-2025 tarihinde https://iris.who.int/items/602f5154-1cbb-4085-91d5-cb032a¬dc640e adresinden ulaşılmıştır.

No authors listed. The uses of epidemiology in the study of the elderly. Report of a WHO Scientific Group on the Epidemiology of Aging. World Health Organ TechRep Ser. 1984;706:1-84.

Kuzu A, Aydın C, Yıldız M, et al. Dünya sağlık örgütü Avrupa Bölgesi’nde yaşlanma ile ilgili seçilmiş bazı ölçütlerin değer¬lendirilmesi. Sürekli Tıp Eğitimi Dergisi. 2019;28(1):17-27

World Health Organization (WHO), (2002), Active Age¬ing: A Policy Framework. Noncommunicable Diseases and Mental Health Cluster, Noncommunicable Diseases Pre¬vention and Health Promotion Department. 13-12-2025 tarihinde https://iris.who.int/server/api/core/bitstream¬s/0418705f-1c82-4fe2-82d6-d4faee89dfa0/content adresin¬den ulaşılmıştır.

Öztürk Z, Uğraş KG. Drug use and polypharmacy in elder¬ly patients. Anatolian Journal of General Medical Research. 2017;27(2):103-8.

Piccoliori G, Mahlknecht A, Sandri M, et al. Epidemiology and associated factors of polypharmacy in olderpatients in primary care: a northern Italian cross-sectional study. BMC Geriatrics. 2021;21(1):197. Published 2021 Mar 20. doi:10.1186/s12877-021-02141-w

Błeszyńska E, Wierucki Ł, Zdrojewski T, Renke M. Pharma¬cological interactions in the elderly. Medicina (Kaunas, Lit¬huania). 2020;56(7):320. Published 2020 Jun 28. doi:10.3390/ medicina56070320

Hoel RW, Giddings Connolly RM, Takahashi PY. Polyphar¬macy Management in Older Patients. Mayo Clinic Proceedin¬gs. 2021;96(1):242-256. doi:10.1016/j.mayocp.2020.06.012

TÜİK.İstatistiklerle-Yaşlılar-2024(08-12-2025tarihinde ht-tps://data.tuik.gov.tr/Bulten/Index?p=%C4%B0statistikler¬le-Ya%C5%9Fl%C4%B1lar-2024-54079&dil=1 adresinden ulaşılmıştır.

Daunt R, Curtin D, O’Mahony D. Polypharmacy steward ship: a novel approach to tackle a major public health crisis. The Lancet. Healthy Longevity. 2023;4(5):e228-e235. doi:10.1016/ S2666-7568(23)00036-3

Midão L, Giardini A, Menditto E, et al. Polypharmacy pre¬valence among older adults based on the survey of health, ageing and retirement in Europe. Archives of Gerontology and Geriatrics.2018;78:213-220. doi:10.1016/j.archger.2018.06.018

Wang X, Liu K, Shirai K, et al. Prevalence and trends of pol¬ypharmacy in U.S. adults, 1999-2018. Global Health Research and Policy. 2023;8(1):25. Published 2023 Jul 12. doi:10.1186/ s41256-023-00311-4

Thompson W, McDonald EG. Polypharmacy and depresc¬ribing in older adults. Annual Review of Medicine. 2024 Jan 29;75:113-127. doi: 10.1146/annurev-med-070822-101947. Epub 2023 Sep 20. PMID: 37729029.

Alhumaidi RM, Bamagous GA, Alsanosi SM, et al. Risk of polypharmacy and its outcome in terms of drug interaction in an elderly population: A Retrospective Cross-Sectional Study. Journal of Clinical Medicine. 2023;12(12):3960. Published 2023 Jun 10. doi:10.3390/jcm12123960

Elkin N. Yaşlılarda Polifarmasi ve Akılcı İlaç Kullanımına Aile Hekimliği Yaklaşımı. İstanbul Gelişim Üniversitesi Sağlık Bi¬limleri Dergisi.2020;11:279-290.

Halli-Tierney AD, Scarbrough C, Carroll D. Polypharmacy: Evaluating risks and deprescribing. American Family Physici¬an. 2019 Jul 1;100(1):32-38.

McLean AJ, Le Couteur DG. Aging biology and geriatric clini¬cal pharmacology. Pharmacological Reviews.2004; 56(2):163- 84.

Nobili A, Marengoni A, Tettamanti M, et al. Association between clusters of diseases and polypharmacy in hospita¬lized elderly patients: resultsfromthe REPOSI study. Euro¬pean Journal of Internal Medicine.2011 Dec;22(6):597-602. doi: 10.1016/j.ejim.2011.08.029. Epub 2011 Sep 29. PMID: 22075287.

Aydos RT. Yaşlılarda akılcı ilaç kullanımı. Eğitimciler için Eğitim Rehberi. Yaşlı Sağlığı Modülleri. T.C. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü. Anıl Matbaacılık AŞ, Ankara, 2011; Bölüm: 37, 413-24.

Nunes BP, Flores TR, Mielke GI, Thumé E, Facchini LA. Mul¬timorbidity and mortality in older adults: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics.. 2016; 67:130-138

TÜİK. İstatistiklerle Yaşlılar, Elderly Statistics, 2023. 5-12- 2025 tarihinde https://data.tuik.gov.tr/Bulten/Index?p=%¬C4%B0statistiklerle-Ya%C5%9Fl%C4%B1lar-2024-54079&¬dil=1 adresinden ulaşılmıştır.

Dumbreck S, Flynn A, Nairn M, et al. Drug-disease and drug-drug interactions: systematic examination of recom¬mendations in 12 UK national clinical guidelines. BMJ : Bri¬tish medical journal / British Medical Association. 2015 Mar 11;350:h949. doi: 10.1136/bmj.h949.

Rochon PA, Gurwitz JH. Optimising drug treatment for el¬derly people: the prescribing cascade. British Medical Journal / British Medical Association. 1997 Oct 25;315(7115):1096-9. doi: 10.1136/bmj.315.7115.1096.

UpToDate. Rochon PA. Drug prescribing for older adults. 2025. (09-12-2025 tarihinde https://www.uptodate.com/con¬tents/drug-prescribing-for-older-adults adresinden ulaşılmış¬tır.

Steinman MA, Landefeld CS, Rosenthal GE, et al. Polyphar¬macy and prescribing quality in older people. Journal of the American Geriatrics Society. 2006 Oct;54(10):1516-23. doi: 10.1111/j.1532-5415.2006.00889.x. PMID: 17038068.

Tseng HM, Lee CH, Chen YJ, et al. Developing a measure of medication-related quality of life for people with polyphar¬macy. Quality of life research: An International Journal of Qua¬lity of Life Aspects of Treatment, Care and Rehabilitation. 2016 May;25(5):1295-302. doi: 10.1007/s11136-015-1177-2. Epub 2015 Nov 19. PMID: 26584811.

Krska J, Morecroft CW, Poole H, et al. Issues potentially af¬fecting quality of life arising from long-term medicines use: a qualitative study. International Journal of Clinical Pharma¬cy. 2013 Dec;35(6):1161-9. doi: 10.1007/s11096-013-9841-5. Epub 2013 Aug 29. PMID: 23990332.

Beijer HJ, de Blaey CJ. Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational stu¬dies. Pharmacy World &Science: PWS.2002 Apr;24(2):46-54. doi: 10.1023/a:1015570104121..

ValzGris A, Farina S, Porcelli M, et al. Polypharmacy ma¬nagement interventions in older adults: An umbrellareview of meta-analyses of randomized controlled trials. Public¬Health. Published online December 4, 2025. doi:10.1016/j. puhe.2025.106077

Liacos M, Page AT, Etherton-Beer C. Deprescribing in older people. Australian Prescriber. 2020 Aug;43(4):114-120. doi: 10.18773/austprescr.2020.033. Epub 2020 Aug 3.

Maher RL, Hanlon J, Hajjar ER. Clinical consequences of pol¬ypharmacy in elderly. Expert Opinion on Drug Safety. 2014 Jan;13(1):57-65. doi: 10.1517/14740338.2013.827660. Epub 2013 Sep 27.

Wang KN, Page AT, Etherton-Beer CD. Mild cognitive impa¬irment: To diagnose or not to diagnose. Australasian Journal on Ageing. 2021 Jun;40(2):111-115. doi: 10.1111/ajag.12913. Epub 2021 Feb 18. PMID: 33604998.

Bishara D, Perera G, Harwood D, et al. Centrally-acting an¬ticholinergic drugs- associations with mortality, hospitali¬sation and cognitive decline following dementia diagnosis in people receiving antidepressant and antipsychotic drugs. Aging and Mental Health. 2022 Sep;26(9):1747-1755. doi: 10.1080/13607863.2021.1947967.

Chandramouleeshwaran S, Khan WU, Inglis F, et al. Impact of psychotropic medications on cognition among older adults: a systematic review. International Psychogeriatrics / IPA. 2024

Dec;36(12):1110-1127. doi: 10.1017/S1041610223000844. Epub 2023 Oct 20.

Scott IA, Gray LC, Martin JH, et al. Minimizing inapprop¬riate medications in older populations: a 10-step concep¬tual framework. The American Journal of Medicine. 2012 Jun;125(6):529-37.e4. doi: 10.1016/j.amjmed.2011.09.021. Epub 2012 Mar 3.

Budnitz DS, Lovegrove MC, Shehab N, et al. Emergency hos¬pitalizations for adverse drug events in older Americans. The New EnglandJournal of Medicine. 2011 Nov 24;365(21):2002- 12. doi: 10.1056/NEJMsa1103053.

Fravel MA, Ernst M. Drug interactions with antihypertensi¬ves. Current Hypertension Reports. 2021 Mar 5;23(3):14. doi: 10.1007/s11906-021-01131-y.

Büyükokuroğlu EM, Tanyeri P, Keleş R. İlaç-İlaç Etkileşimleri Konusunda Farkındalık. Online Türk Sağlık Bilimleri Dergi¬si.2019;4(3):377-391

UpToDate.09-12-2025 tarihinde https://www.wolterskluwer. com/en/solutions/uptodate/resources/lexidrug-user-aca¬demy adresinden ulaşılmıştır.

Duman ÇN. İlaç etkileşimleri. Sağlık bilimlerinde güncel araştırmalar ve pratik bilgiler 2. İçinde: Uzun Y, Doğan A,Bat¬tal A (eds.). Ankara: Iksad Publishing House. 2023:151-174. DOI: https://dx.doi.org/10.5281/zenodo.8372997

Fernández A, Gómez F, Curcio CL, et al. Prevalence and impact of potentially inappropriate medication on commu¬nity-dwelling older adults. Biomédica:revista del InstitutoNa¬cional de Salud. 2021 Mar 19;41(1):111-122. doi: 10.7705/ biomedica.5787.

ARSLAN ŞE, Dağcıoğlu BF. Uygunsuz İlaç Kullanımı Açısın¬dan 2015 ve 2019 AGS Beerskriterleri arasında klinik olarak anlamlı fark var mı: Kesitsel bir çalışma. Ankara Medical Jour¬nal. 2020;20(4):1027-1040. doi:10.5505/amj.2020.24654.

Unutmaz GD, Soysal P, Tuven B, Isik AT. Costs of medication in older patients: before and after comprehensive geriatric as¬sessment. Clinical Interventions in Aging. 2018 Apr9;13:607- 613. doi: 10.2147/CIA.S159966.

Doğan AB, Canbolat Ö. Yaşlılarda kırılganlığın önlenmesi ve yönetiminde kanıta dayalı yaklaşımlar. Sağlık Bilimlerinde Değer.2023;13(3):501-507.doi: https://dx.doi.org/10.33631/ sabd.1110895

Ateş Bulut E, Soysal P, Işık AT. Frequency and coincidence of geriatric syndromes according to age groups: single-center experience in Turkey between 2013 and 2017. Clinical Inter¬ventions in Aging. 2018 Oct4;13:1899-1905. doi: 10.2147/CIA. S180281.

Arslan M, Keskin Arslan E, Koç EM, et al. Relationship betwe¬en frailty and medicine use and polypharmacy in people over sixty-five years of age. TheMedical Bulletin of Haseki. 2020 Feb 18;58(1):33-41. doi: 10.4274/haseki.galenos.2019.5409.

Beğer T. Kırılgan yaşlı. Turkish Journal of Physical Medicine and Rehabilitation. 2006;52(1)(Özel Ek A): A18-A22

Dhalwani NN, Fahami R, Sathanapally H, et al. Association between polypharmacy and falls in older adults: a longitudi¬nal study from England. BMJ Open. 2017;7(10):e016358. Pub¬lished 2017 Oct 16. doi:10.1136/bmjopen-2017-016358

Maly J, Dosedel M, Vosatka J, et al. Pharmacotherapy as major risk factor of falls -analysis of 12 months experience in hospitals in South Bohemia. Journal of Applied Biomedici¬ne.2019;17(1):60. doi:10.32725/jab.2019.001

Abdu N, Mosazghi A, Teweldemedhin S, et al. Non-Ste¬roidal Anti-InflammatoryDrugs (NSAIDs): Usage and co-prescription with other potentially interacting drugs in elderly: A cross-sectional study. Public Library of Science one. 2020;15(10):e0238868. Published 2020 Oct 9. doi:10.1371/ journal.pone.0238868

Marttinen MK, Kautiainen H, Haanpää M, et al. Analge¬sic purchases among older adults- a population-basedstudy. BMC Public Health. 2021;21(1):256. Published 2021 Jan 31. doi:10.1186/s12889-021-10272-3

Ingrasciotta Y, Sultana J, Giorgianni F, et al. Analgesic drug use in elderly persons: A population-based study in Southern Italy. Public Library of ScienceOne. 2019;14(9):e0222836. Pub¬lished 2019 Sep 19. doi:10.1371/journal.pone.0222836

Bythe 2019 American Geriatrics Society BeersCriteria® up¬date expert panel. American Geriatrics Society 2019 updated AGS beers criteria® for potentially inappropriate medication use in older adults. Journal of theAmerican Geriatrics Society. 2019;67(4):674-694. doi:10.1111/jgs.15767

McDonald DD. Predictors of gastrointestinal bleeding in older persons taking nonsteroidal anti-inflammatory drugs: Results from the FDA adverse events reporting system. Journal of the American Association of Nurse Practitioners. 2019;31(3):206- 213. doi:10.1097/JXX.0000000000000130

Thomas MC. Diuretics, ACE inhibitors and NSAIDs--the trip¬le whammy. TheMedical Journal of Australia. 2000;172(4):184- 185. doi:10.5694/j.1326-5377.2000.tb125548.x

bpac.org.nz. Non-steroidal anti-inflammatory drugs (NSAI¬Ds): Making safer treatment choices. Best Practice Journal: 2013;55. 9-12-2025 tarihinde https://bpac.org.nz/BPJ/2013/ October/docs/BPJ55-pages8-19.pdf adresinden ulaşıldı.

Kinoshita Y, Ishimura N, Ishihara S. Advantages and disad¬vantages of long-term proton pump inhibitor use. Journal of Neurogastroenterology and Motility. 2018;24(2):182-196. doi:10.5056/jnm18001

Chang TI, Park H, Kim DW, et al. Polypharmacy, hospi¬talization, and mortality risk: a nation wide cohort study. Scientific Reports. 2020;10(1):18964. Published 2020 Nov 3. doi:10.1038/s41598-020-75888-8

Pazan F, Wehling M. Polypharmacy in older adults: a narrati¬ve review of definitions, epidemiology and consequences. Eur GeriatrMed. 2021;12(3):443-452. doi:10.1007/s41999-021- 00479-3

77 Holmes HM, Hayley DC, Alexander GC, et al. Reconside¬ring medication appropriateness for patients late in life. Arc¬hives of Internal Medicine. 2006;166(6):605-609.doi:10.1001/ archinte.166.6.605

Mitchell SL, Teno JM, Kiely DK, et al. The clinical course of advanced dementia. The New England Journal of Medici¬ne2009;361(16):1529-1538. doi:10.1056/NEJMoa0902234

Givens JL, Jones RN, Shaffer ML, Kiely DK, Mitchell SL. Survi¬val and comfort after treatment of pneumonia in advanced de¬mentia. Archives of Internal Medicine2010;170(13):1102-1107. doi:10.1001/archinternmed.2010.181

Steinman MA, Hanlon JT. Managing medications in clinically complex elders: “There’s gotto be a happy medium”. Journal of the American Medical Association. 2010;304(14):1592-1601. doi:10.1001/jama.2010.1482

George CJ, Jacobs LG. Geriatrics medication management rounds: a novel approach to teaching rational prescribing with the use of the medication screening questionnaire. Jour¬nal of the American Geriatrics Society.2011;59(1):138-142. do¬i:10.1111/j.1532-5415.2010.03231.x

Boyd CM, Darer J, Boult C, et al. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. Journal of the American Medical Association. 2005;294(6):716-24

78. Whelton PK, Appel LJ, Espeland MA, et al. Sodium reducti¬on and weight loss in thetreatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. Journal of theAmerican Medical Association

1998;279(11):839-846. doi:10.1001/jama.279.11.839

Turner MR, Camacho X, Fischer HD, et al. Levothyroxine dose and risk of fractures in older adults: nestedcase-control study. British Medical Journal / British Medical Association. 2011;342:d2238. Published 2011 Apr 28. doi:10.1136/bmj. d2238

Wolf MS, Curtis LM, Waite K, et al. Helping patients simplify and safely use complex prescription regimens. Archives of In¬ternal Medicine.2011;171(4):300-305. doi:10.1001/archintern¬med.2011.39

Wolf MS, Shekelle P, Choudhry NK, et al. Variability in phar¬macy interpretations of physician prescriptions. Medical Care. 2009;47(3): 370-373.doi:10.1097/MLR.0b013e31818af91a

Akıcı A, Uğurlu MÜ, Gönüllü N et al. Pratisyen hekimlerin akılcı ilaç kullanımı konusunda bilgi ve tutumlarının değer¬lendirilmesi. Sürekli Tıp Eğitimi Dergisi. 2002:11(7);253-257

Mete S, Özdil K. Türkiye’de akılcı ilaç kullanımına yönelik öl¬çekler. Journal of Health Sciences. Aralık 2023;32(3):424-432. doi:10.34108/eujhs.1323068

No authors.Therationaluse of drugs and WHO. Dev Dialogue. 1985;(2):1-4.

https://www.who.int/. Promoting rational use of medicines. 1-12-205 tarihinde https://www.who.int/activities/promo¬ting-rational-use-of-medicines adresinden ulaşılmıştır.

https://iris.who.int/home. 5-12-2025 tarihinde World Health Organization (2002). Promoting rational use of medicines: core components. World Health Organization. World Health Organization. https://iris.who.int/server/api/core/bitstreams/ a6a8b03f-4c9f-4b5c-b89d-48279cd1293a/content adresinden ulaşılmıştır.

Yılmaz M, Güler N, Güler G, et al. Bir grup kadının ilaç kulla¬nımı ile ilgili bazı davranışları: Akılcı mı? Cumhuriyet Medical Journal. 2011;33(3):266-77

Aksoy, M, Alkan, A, İşli F. Sağlık Bakanlığı’nın akılcı ilaç kul-lanımını yaygınlaştırma faaliyetleri. Türkiye Klinikleri Journal of Pharmacology-Special Topics. 2015;3(1):19-26.

Gülmez SE. Türk Farmakoloji Derneği. Dünyada akılcıl ilaç kullanımı uygulamalarına genel bir bakış. 28-11-2025 tarihin¬de https://www.tfd.org.tr/sites/default/files/Klasor/Dosyalar/ ebultenler/ktcg/55_2_ezgi_gulmez_yazi_55.pdf adresinden ulaşılmıştır.

Aktay G, Hancı Hİ, Balseven A. İlaç etkileşimleri ve hekim sorumluluğu. Sürekli Tıp Eğitimi Dergisi. 2003:12(7):261–264.

Ergün Y, Altıntaş Aykan D. Akılcı ilaç kullanımında genel il¬keler. Arşiv Kaynak Tarama Dergisi. Mart 2019;28(1):19-27. doi:10.17827/aktd.405358

Gülhan R. Yaşlılarda akılcı ilaç kullanımı. Okmeydanı Tıp Dergisi. 2013; 29(Ek sayı 2):99-105. doi:10.5222/otd. supp2.2013.099

Ambwani S, Mathur AK. Chapter-2: rational drug use. Health Administrator. 2006;19(1):5-7.

Balcıoğlu H., Bilge YŞ, Bilge U et al. İçinde: BilgeU, Ünlüoğlu İ (eds.). Aile Hekimliğinde Akılcı İlaç Kullanımı. İstanbul: Ta¬hev Yayınları;2019. p. 49-86.

İskit A, Kayaalp SO. İlaçların Etkisini Değiştiren Faktörler. İçinde: Kayaalp SO ed. Akılcıl Tedavi Yönünden Tıbbi Farma¬koloji, 13: Ankara, Pelikan Yayıncılık. 2012. p.90-103.

De Vries TPGM, Henning RH, Hogerzeil HV, et al. Guide to good prescribing. World Health Organization Action Prog¬ramme on Essential Drugs Geneva, 1994.

le Grand A, Hogerzeil HV, Haaijer-Ruskamp FM. Interventi¬on research in rational use of drugs: a review. Health Policy and Planning. 1999 Jun;14(2):89-102. doi: 10.1 093 /heapol/ 14.2.89. PMID: 10538724.

SürmelioğluN, Kıroğlu O,Erdoğdu T, et al. Akılcı olmayan ilaç kullanımını önlemeye yönelik tedbirler. Archives Medical Re¬view Journal 2015;24(4):452-462.

Altındiş S. Akılcı ilaç kullanımına sistematik bir bakış. J Bio¬technol and Strategic Health Res. Ekim 2017;1(2):34-38

O’Mahony D, Cherubini A, Guiteras AR, et al. STOPP/ START criteria for potentially inappropriate prescribing in older people: version 3. European Geriatric Medicine. 2023 Aug;14(4):625-632. doi: 10.1007/s41999-023-00777-y. Epub 2023 May 31. Erratum in: Eur Geriatr Med. 2023 Aug;14(4):633. doi: 10.1007/s41999-023-00812-y.

Bahat G, Ilhan B, Erdogan T, et al. Turkish inappropria¬te medication use in the elderly (TIME) criteria to improve prescribing in older adults: TIME-to-STOP/TIME-to-START. European Geriatric Medicine. 2020 Jun;11(3):491-498. doi: 10.1007/s41999-020-00297-z. Epub 2020 Mar 5.

akademikgeriatri.org. 22-11-2025 tarihinde https://akade-mikgeriatri.org/icerik/haberler-ve-duyurular-5/turkiye-yas¬lida-uygunsuz-ilac-kullanim-kriterleri-67 adresinden ulaşıl¬mıştır.

https://apps.apple.com. 9-12-2025 tarihinde https://apps. apple.com/tr/app/time-criteria/id1560761256 adresinden ulaşılmıştır.

Bythe 2023 American Geriatrics Society Beers Criteria® Up¬date Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society. 2023 Jul;71(7):2052-2081. doi: 10.1111/jgs.18372. Epub 2023 May 4.

99-https://play.google.com/store/games. 10-12-2025 tarihin¬de https://play.google.com/store/apps/details?id=com.ags. beers&hl=tr adresinden ulaşılmıştır.