Study: Seniors being overmedicated

August 1, 2003

Pharmaceutical Representative

The number of seniors subjected to potentially dangerous overmedication has more than doubled since 1999.

The number of seniors subjected to potentially dangerous overmedication has more than doubled since 1999, according to data released by Franklin, NJ-based pharmacy healthcare services provider Medco Health Solutions Inc.

In 2002, approximately 7.9 million medication alerts were flagged by Medco Health's targeted senior drug utilization review system, more than twice the approximately 3.4 million alerts detected in 1999 for the more than 6.3 million seniors covered by Medco Health who filled prescriptions.

Of the 7.9 million alerts in 2002, roughly 2.2 million situations involved exceeding the clinically recommended dose for seniors age 65 and older, and approximately 2.4 million involved prescribing a drug that is clinically inappropriate in the elderly and may lead to harm. More than 3 million involved interactions between two or more medications.

"Not every alert posted is cause for alarm," said Robert Epstein, chief medical officer at Medco Health. "However, we frequently find incidents with anti-anxiety medications and sleep aids that are prescribed at too high a dose for seniors, which can in turn cause confusion and falling. In addition, we often see concurrent use of blood thinners and aspirin-like drugs which can cause bleeding; and we find many patients being prescribed both beta agonists for lung issues and beta blockers for the heart, which may cancel each other out or lead to a worsening of one or both conditions."

Multiple treatments

Epstein said the increase in alerts has been caused by the number of different doctors, pharmacies and medications seniors use. "These large numbers are due, in part, to the expansion of a patient's healthcare team to include primary care physicians, multiple specialists and pharmacists," said Epstein. "The data raises our awareness about the need for better communication between healthcare providers and obtaining and maintaining complete medication histories so that changes in therapies can be made, when appropriate, as patients age and are prescribed additional drugs."

Medco found that one in four seniors sees four or more physicians and nearly one in ten seniors was prescribed medications by six or more doctors in 2002. One in three used four or more different pharmacies, and one in seven seniors used five or more pharmacies to fill prescriptions last year.

"The senior population has unique and special characteristics when it comes to their pharmaceutical care," said Epstein. "Clearly it is becoming increasingly difficult for patients and physicians to track appropriate prescription medication use." PR

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