Many elderly take potentially harmful drugs

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Many elderly take potentially harmful drugs

By Suzanne Rostler

NEW YORK, Dec 11 (Reuters Health) - More than one in five elderly

Americans living on their own takes a medication that could put them at

risk for injuries and illness, results of a study reveal.

According to the report in the December 12th issue of The Journal of the

American Medical Association, more than 21% of elderly

Americans--representing nearly 7 million individuals--had received at

least one of these 33 potentially inappropriate medications in 1996.

Nearly 3% used a medication that elderly people should always avoid,

including certain sedatives, long-acting drugs to bring down blood sugar

levels, pain relievers and drugs to quell nausea. Patients in poor

health, women and those who took the most medications were more likely

to have been prescribed a potentially dangerous drug, the study found.

" Suboptimal prescribing is a common problem in the elderly, " Dr. Chunliu

Zhan from the Agency for Healthcare Research and Quality in Rockville,

land, and the study's lead author, told Reuters Health. Zhan

suggests that educating doctors and patients and conducting further

research into the effectiveness of medications in elderly patients can

help solve the problem.

The study findings are based on a review of data from a 1996 survey on

more than 2,400 US individuals aged 65 an older, who answered questions

about their use of medications, insurance coverage and expenditures. A

seven-member panel with expertise in geriatrics and pharmacy reviewed

the information and categorized inappropriate medication use and

potentially inappropriate use against an accepted list.

In an interview, Zhan said the findings probably represent " just the tip

of the iceberg " because the researchers did not examine interactions

between drugs, interactions between drugs and diseases, the misuse of

drugs not on the list or the underuse of effective drugs.

The fault, Zhan said, lies with doctors, patients and researchers

conducting studies on the safety and efficacy of drugs. Clinical trials

usually exclude elderly people, especially those who have more than one

condition. Doctors caring for elderly patients may not have special

training in geriatric care, and patients may demand certain medications

that have worked for them in the past.

Dr. Jerry Avorn from Harvard Medical School in Boston, Massachusetts,

blames the trend on physicians' habits and not on the promotion of

medications by the drug industry. In an interview with Reuters Health,

Avorn suggested that doctors caring for older patients reassess all

medications a patient is using at least twice a year.

" This provides an opportunity for the doctor to find out just what the

patient is getting from other physicians, or over the counter--and the

results are often pretty surprising, " he said. " It also makes it

possible to find out what the patient isn't taking any more, but perhaps

should be, for example, drugs that were stopped because of side effects

or because the patient couldn't afford them. "

SOURCE: The Journal of the American Medical Association

2001;286:2823-2829, 2866-2868.