'Inappropriate' use of prescription drugs putting oldies at risk

A new study has found that many elderly people are risking their health by taking prescription medicines "inappropriately."

The study from Belgium also found a link between underuse, not taking essential medications, and an increased risk of dying or needing to be hospitalized.

Appropriate prescribing of medications is a major challenge in the care of elderly adults because older patients tend to be more sensitive to the effects of medications than younger patients, and they often have multiple conditions requiring numerous prescriptions that could negatively interact with each other.

To examine patterns of prescription drug use in elderly adults, Maarten Wauters of Ghent University and his colleagues studied 503 community-dwelling adults aged 80 years and older for a period of 18 months.

The researchers found that 58 percent of patients were taking five or more chronic medications daily. Few patients were taking medications appropriately, with underuse occurring in 67 percent of patients and misuse occurring in 56 percent of patients (with some overlap between these groups). Just 17 percent of the population were not affected by any kind of underuse or misuse.

Over the 18-month study period, underuse was associated with 39 percent and 26 percent increased risks of mortality and hospitalization, respectively, per underused medication. Associations with misuse were unclear.

"Taking too many medications or unsafe medications are known to cause adverse health outcomes; however, we have shown that not taking essential, beneficial medications is more frequent and can be more strongly associated with negative outcomes," said Wauters. "Prescribing medications to older persons should be done after careful thought, balancing the benefits and risk of every medication at regular intervals."

Wauters noted, "Clinical pharmacologists can help prescribers to clearly assess misuse and underuse of medications in full knowledge of the patient, their comorbidities, and their medications. They can help to build electronic systems for constant monitoring of the quality of prescribing, using evidence-based criteria of potentially inappropriate prescribing."

The study is published in the British Journal of Clinical Pharmacology.