It’s not unusual for an older adult to have a list of prescription medications for various chronic and acute illnesses. And, as people age, they can develop new conditions that require even more prescription drugs. The more conditions, the more drugs.
But a new study by researchers from the University of Buffalo revealed that one-third of older adults in the US are treated with drugs that are not appropriate for their illness. This can lead to serious problems, including hospitalization and death.
When two or more drugs are taken together, they may clash and produce an undesirable effect. This is a drug-drug interaction. A drug-disease interaction, on the other hand, occurs when a drug addresses one disease but may have a negative or unpredictable effect on the other disease. At first, the doctor may prescribe yet more medications to manage the unwanted effects – but those new drugs can cause even more problems. The term for this is “prescribing cascade.”
The Canadian Deprescribing Network, a group of healthcare professionals, researchers, patients and other interested parties, says that seniors are five times more likely than younger adults to be hospitalized because of harmful medication effects. It’s not just the number of drugs that can make them dangerous, but how the body reacts to medications as people age:
- Medications can take longer to work in an older person. This is due to the body having less muscle and more body fat.
- The medications may be more concentrated, as the body tends to have less water in later years.
- The kidneys and liver don’t filter the drugs as well as they once did.
- The brain can become more sensitive to the effects of the medications.
Excessive or Inappropriate Prescribing
The researchers from the University of Buffalo reviewed medications prescribed for 218 million seniors, including antidepressants, barbiturates, hormones, nonsteroidal anti-inflammatory drugs (NSAIDs), antihistamines and antipsychotics. They found that 34.4% of older patients were prescribed at least one inappropriate medication.
“Although efforts to de-prescribe have increased significantly over the last decade, potentially inappropriate medications continue to be prescribed at a high rate among older adults in the United States,” said lead investigator David Jacobs, PharmD, PhD, in a press release. Dr. Jacobs is an assistant professor of pharmacy practice in the University of Buffalo School of Pharmacy and Pharmaceutical Sciences.
Healthcare costs
Aside from the toll that inappropriate prescriptions or excessive prescriptions takes on patients, there is also a financial aspect. According to the researchers, the over-prescriptions were linked to higher costs: outpatient visits at $116, prescription medications at $128, and total healthcare expenses at $458. Increased hospitalizations and costs to the patients can be more than $450 per year, the researchers said.
The Take Away
For some people, multiple prescriptions are necessary. Do not stop taking any medications without your doctor’s knowledge. Some medications must be tapered slowly, while stopping others could cause serious problems.
If you do have multiple prescriptions, there are some ways that may protect your health – and your wallet:
- Learn about your prescriptions. Ask your doctor why the drug is prescribed. Ensure that all other medications you take are in your records. You can also ask how the new drug or drugs will affect your other health conditions. Your pharmacist can also help you with drug-related questions.
- When you get your new prescriptions, ask your pharmacist if there is anything you should be aware of regarding how your new drugs may interact with the other ones. Should you take them at the same time? Should you take them at different times of the day, and so on.
- Track new symptoms after you start a new medication or your doses change. Speak to your pharmacist or doctor if you notice anything new.
- Get a regular medication review. Sometimes, people are on prescription drugs for so long that they are taken for granted. Have your doctor do a regular prescription review of all your medications – even those that were prescribed by a specialist. This is to ensure that the drugs will work together and may only cause reasonable side effects.
- Stick with one pharmacy as much as possible. The pharmacist will have your file with all your medications and can flag any problems with drug interactions.
Ralph Chen is an enthusiast of medical topics and advanced technologies. When not writing, he spends time playing popular PC games.