America’s Other Drug Problem: Multiple Prescriptions for Hospitalized Elderly

Polypharmacy is huge problem, expert says

An increasing number of elderly patients nationwide are receiving multiple medications to treat chronic diseases, increasing their chances of dangerous drug interactions and serious adverse effects, according to an article posted on the Kaiser Health News (KHN) website. Often the drugs are prescribed by different specialists who don’t communicate with each other. If those patients are hospitalized, doctors making the rounds add to the list—and some of the drugs they prescribe may be unnecessary or unsuitable.

“This is America’s other drug problem—polypharmacy,” said Dr. Maristela Garcia, director of the inpatient geriatric unit at the UCLA Medical Center in Santa Monica. “And the problem is huge.”

Some drugs can cause confusion, falling, excessive bleeding, hypotension, or respiratory complications in elderly patients.

Older adults account for approximately 35% of all hospital stays but for more than half of the visits that involve drug-related complications, according to the Department of Health and Human Services. Such complications add approximately three days to the average hospital stay, the agency said.

Data on financial losses linked to medication problems among elderly hospital patients are limited, according to the KHN article. But the Institute of Medicine determined in 2006 that at least 400,000 preventable adverse drug events occur each year in American hospitals. Such events, which can result from the wrong prescription or the wrong dosage, pushed health care costs up by approximately $3.5 billion in 2006.

Moreover, even if a drug doesn’t cause an adverse reaction, that doesn’t mean the patient necessarily needs it, according to KHN. A study of Veterans Affairs hospitals showed that 44% of frail elderly patients were given at least one unnecessary drug at discharge.

Some drugs prescribed in the hospital are intended to treat the acute illnesses for which the patients were admitted; others are to prevent problems, such as nausea or blood clots; and still others are meant to control the adverse effects of the original medications.

In addition, when doctors in the hospital change or add to the list of medications, patients often return home uncertain about what to take. If patients have dementia or are unclear about their medications, and they don’t have a family member or a caregiver to help, the consequences can be disastrous, KHN says.

Having a pharmacist on the team caring for older patients can reduce drug complications and hospitalizations, according to a 2013 analysis of several studies published in the Journal of the American Geriatrics Society.

Source: Kaiser Health News; August 30, 2016.