A study by researchers in the University of Toronto finds that the long and growing list of prescription drugs consumed by elderly is actually making them more likely to end up in hospital. The risk of having to visit a hospital climbs with each additional medication prescribed, the average being seven different drugs a year, the researchers find.
The study underscores the mounting concern about “polypharmacy,” whose perils include side effects from powerful sedatives, anti-psychotics or opioids, and reactions between incompatible drugs. The researchers recommend increased monitoring of doctors’ prescribing habits and more awareness by patients of the issue.
Experts not involved in the research say the issue is complex - it’s important not to under-treat patients with several ailments - but confirm that excessive prescribing is a serious problem. Problems can arise because of lack of co-ordination between doctors and pharmacists, pressure from patients or a multi-medication “cascade” - additional drugs used to treat side effects of existing pills, said Dr Roger Wong, a geriatrician at the University of British Columbia.
Another Canadian study found that four in 10 older people were prescribed at least one drug deemed inappropriate under specialist guidelines. The study concluded that the more drugs they took, the more likely they were to end up in hospital. The chance of visiting the emergency department climbed three to four per cent with each extra medicine, and of being admitted to hospital by two to three per cent.
Prescription drugs can obviously be vital to a person’s health, but physicians should always ask themselves whether an extra drug’s benefits will outweigh its risks and try to “clean up the mess” of multiple prescriptions when a patient is moving from one location to another, said Wong. Doctors also need to manage the expectations of patients and family members who insist on drug treatment for each new problem, he said.
