Overmedication imperils seniors, studies say - East Valley Tribune: Health

Overmedication imperils seniors, studies say

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Posted: Wednesday, May 18, 2011 7:30 pm

The overmedication of America's seniors is both widespread and often deadly, a growing collection of research and government reports show.

Across all ages, the number of people treated in U.S. hospitals for illness and injuries from taking medicines jumped 52 percent to nearly 2 million overall, according to an April report from the federal Agency for Healthcare Research and Quality.

But that report and another released by the Substance Abuse and Mental Health Services Administration (SAMSHA) in March noted that 53 percent of those hospitalized for adverse reactions or other problems with medications were 65 or older, as were nearly 62 percent of those seen at emergency rooms.

The two reports use different surveillance systems, one tracking most hospital admissions, the other a select network of emergency departments around the country. But they send similar messages about the risks older people face from side effects, which often worsen due to weight changes or other physical shifts during aging, and concurrent use of many drugs.

The SAMSHA study found that nearly 80 percent of the hospital visits by patients 50 and older involved adverse reactions to a single drug, with narcotics and non-narcotic pain relievers responsible for nearly a quarter of the trips. But tranquilizers, anti-depressants, psychotherapeutic drugs, blood thinners and other drugs to prevent heart disease and stroke were also frequently blamed.

A third study, published online in February in the Annals of Emergency Medicine, took a closer look at the experiences of 1,000 Canadian ER patients of all ages, including 122 who came in due to an adverse drug event.

Researchers at the University of British Columbia in Vancouver said the patients seen for drug events were no more likely to die over the next six months than the rest of the study group. But their care cost 90 percent more, and the risk of spending additional days in the hospital was 50 percent greater.

The researchers noted that while some of the patients had deliberately misused drugs, most were experiencing side effects or not taking the drugs as directed.

Other studies have pegged the total cost of treating medication-related problems in the U.S at more than $200 billion a year.

Other research indicates that seniors in their 60s typically take an average of seven different medications a day; by the time they reach their 80s, the average nearly doubles.

Yet a recent study by scientists at Northwestern University found that many older patients are so confused by vague instructions on their medicine bottles that they fail to take doses in a timely manner and are particularly likely to try taking the medicines at different times of the day rather than grouping them at similar intervals.

For instance, if one bottle says take a pill every 12 hours and another says take a dose twice a day, nearly 80 percent of the 464 patients in the study would not take the pills at the same time.

But while dosing and other mistakes by seniors or their caregivers are common, a recent report on the heavy use of powerful antipsychotic drugs for nursing home patients raises disturbing questions about the role of drug companies, nursing home pharmacists and attending physicians in managing care of elders.

The report by the Inspector General of the Department of Health and Human Services found that 14 percent of nursing home residents -- more than 300,000 -- had at least one Medicare claim in the first half of 2007 for drugs such as Risperidone, Quetiapine and Clozapine, even though they had not been diagnosed with schizophrenia or bipolar disorder.

"Potentially most alarming, 88 percent of the time these drugs were prescribed for elderly patients with dementia, a population the FDA has warned faces an increased risk of death from this class of drugs,'' Inspector General Daniel Levinson wrote in a summary of the 48-page report.

The drugs all carry specific "black box" labels warning of the increased risk of death to dementia patients if they take the drugs, which many critics suspect have been used to sedate demented patients and make them easier to manage. Others, including Levinson, say drug company marketers offered deals on the drugs to nursing homes in a bid to pump up sales.

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