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Warning over inappropriate prescribing of meds
New research on adverse events in over-65s
Mar 21, 2017
Deborah Condon
New research has highlighted the dangers surrounding the inappropriate prescribing of medications to older people in Ireland.
According to the findings, inappropriate prescribing, or failing to prescribe recommended medications, can lead to adverse drug events, some of which will require hospitalisation.
The research, which comes from the Royal College of Surgeons in Ireland (RCSI), the Health Research Board (HRB) and Trinity College Dublin, focused on potentially inappropriate prescribing (PIP) in people over the age of 65. PIP refers to:
-The use of a medication in a way that its risks outweigh its benefits
-The prescribing of a medication where a better alternative exists
-The under-use or omission of appropriate medications from a prescription.
The researchers found that the inappropriate prescribing of medications was linked with a 29% increased rate of adverse drug events in the older people studied.
While many of these adverse events were mild, such as bruising easily, heartburn and dizziness, some relatively severe adverse events led to the hospitalisation of the person involved.
Not surprisingly, the research noted that healthcare use was higher among those taking more than one type of inappropriate medication, as well as those who had not been prescribed a potentially beneficial medicine.
In fact, this was linked with a 15% increase in the rate of visits to GPs and a 40% jump in Emergency Department (ED) visits.
Examples of PIP included the prescribing of proton pump inhibitors, which are commonly used for gastric problems, to patients at high doses for more than eight weeks.
Meanwhile, the most common medication omissions included calcium and vitamin D supplements for patients with osteoporosis.
The researchers explained that older people are particularly vulnerable to the adverse effects of medications because ageing can affect how the body processes and reacts to medicines. Older people are also more likely to be taking multiple medications for a number of conditions and these may react with each other.
"At a time of unprecedented strain on our EDs, these findings are a reminder that a range of factors can contribute to a person's risk of attending hospital. There is no single solution to this issue, however facilitating effective management of older people's conditions, specifically improving their medicines in primary care, may make a positive contribution," commented one of the research's lead authors, Dr Frank Moriarty, of the RCSI.
The findings comes from two studies, one involving over 900 people aged 70 and older, and the other involving around 1,700 medical card patients. Details of their findings are published in the Journal of Gerontology and the British Journal of Clinical Pharmacology.