Half of elderly patients given ‘inappropriate medicine’ by GPs

MORE THAN half of elderly patients were prescribed unsuitable and, in some cases, potentially lethal medicines by their GPs, a new study has found.

The study of 600 hospitalised elderly patients by experts at Cork University Hospital (CUH) found that in almost six out of 10 cases GPs had not prescribed the best medicine to treat a specific condition.

It discovered that 52% of patients had been prescribed drugs that could counteract another drug that a patient was already taking to treat a different condition, and cause an adverse reaction.

The study, to be published in the British Journal of Clinical Pharmacy and Therapeutics this month, also found that GPs were responsible for up to 90% of inappropriate prescribing.

One of the report authors, geriatric consultant, Dr Denis O’Mahony, said problems arose because patients were taking lots of prescription drugs to treat a variety of conditions. Patients were also being prescribed drugs unsuitable for the kind of chronic illnesses they were suffering from and sometimes ones that counteracted with another medicine.

Dr O’Mahony stressed, however, that the study concentrated on frail, elderly patients who were admitted to hospital suffering from an acute illness.

“It certainly would not be true to say that half of all people over the age of 65 are taking inappropriate medication,” he stressed.

While most of the errors identified were not serious, had not caused an adverse reaction and were easily corrected, a significant minority of cases emerged where wrong or inappropriate prescribing might have resulted in the death of a patient, the study found.

Dr O’Mahony said thereal challenge for GPs was finding the most appropriate treatment for sick and frail elderly patients and that education in this area of medicine was critical.

Irish College of General Practitioners (ICGP) spokesperson, Dr Niall Ó Cléirigh, said the study was alarmist.

Dr Ó Cléirigh said there was often no consensus as to what constituted the best prescription for a particular condition. A GP might have valid reasons for prescribing the medication that a medical specialist might consider inappropriate, he said.

“The study gives a false impression that there are a significant number of prescribing errors occurring in primary care and I would disagree with that,” he said.

Dr Ó Cléirigh said the ICGP had been running courses in therapeutics for many years and strongly encouraged GPs to keep up to date by availing of them.