Rational prescribing for patients with a reduced life expectancy

Optimal prescribing for patients who are in late life and have multiple comorbid illnesses remains unclear despite the increasing recognition that chronic diseases should be managed differently in the setting of reduced life expectancy. As new diseases are diagnosed and chronic comorbidities worsen with advancing age, more and more medications are added in accordance with disease-specific clinical practice guidelines. The result is often a complex drug regimen that is difficult to manage. This occurs regardless of the appreciation that the ongoing benefits and risks of chronic treatments are uncertain as diseases become life-defining or life-limiting.