Prescription risk for older people

Inappropriate medicine prescriptions are being blamed for significantly increasing the number of older people being admitted to hospital, according to two new studies.

For 2,600 older people examined over two years, unsuitable prescribing was associated with a 29% higher rate of adverse drug events.

Researchers from the Royal College of Surgeons in Ireland and the Health Research Board, in collaboration with researchers from Trinity College Dublin, linked inappropriate prescriptions to more visits to the GP and hospital emergency departments.

Visits to emergency departments increased by 40%, while GP visits rose 15% among those taking more than one inappropriate medication, as well as those not taking a potentially beneficial drug. 

The types of events reported were mainly mild, such as easy bruising, difficulty stopping bleeding from a small cut, heartburn, and dizziness. However, a few relatively severe events led to the patient being hospitalised.

Some of the most frequent types of medicines being prescribed included proton pump inhibitors, a group of drugs used to treat gastric problems. These were prescribed to patients at high dosages for more than eight weeks.

Also, non-steroidal anti-inflammatory drugs are being prescribed long-term, or to patients with high blood pressure.

The most frequent prescription omissions of potentially beneficial medicines are calcium and vitamin D supplements, in patients with osteoporosis, and the under-treatment of patients reporting an abnormal heart rhythm.

The studies, published in the Journal of Gerontology and the British Journal of Clinical Pharmacology, investigated how potentially inappropriate prescribing in people over the age of 65, in primary care, can have adverse effects on their health.

The lead author of one of the studies, and post-doctoral researcher at the HRB Centre for Primary Care Research at RCSI, Dr Frank Moriarty, said there is no single solution.

“However, facilitating effective management of older people’s conditions, specifically improving their medicines, in primary care, may make a positive contribution,” he said.


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