Polypharmacy: keeping the elderly safe: because they take more medications than younger patients, the elderly have a higher risk of adverse reactions. Here's how to help your older patients avoid trouble

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Authors: James Wooten and Julie Galavis
Date: Aug. 2005
From: RN(Vol. 68, Issue 8)
Publisher: UBM LLC
Document Type: Cover story
Length: 3,291 words

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If your elderly patient takes several medications at the same time, he's at high risk for drug-related problems. (1) Elderly patients are particularly susceptible to polypharmacy issues not only because aging affects how their body handles medications, but because they take more medications than younger patients: In the United States, people over 65 make up approximately 13% of the population but use about 30% of all prescriptions written. (2) At any given time, an elderly patient takes, on average, four or five prescription drugs and two over-the-counter (OTC) medications. (3)

An elderly patient is also more likely to be taking a medication that has been prescribed inappropriately--one that's unnecessary, ineffective, or potentially dangerous--and to suffer an adverse drug event (ADE). In a study of more than 150,000 elderly patients, 29% had received at least one of 33 potentially inappropriate drugs. (4) A study of approximately 27,600 Medicare patients documented more than 1,500 ADEs in a single year. (5)

Most ADEs are the result of drug interactions; the more drugs a patient takes, the higher the risk of interactions. (6) The estimated incidence of drug interactions rises from 6% in patients taking two medications a day to as high as 50% in patients taking five a day. (7)

As the elderly population in the United States continues to grow, so will the incidence of ADEs. You can help your elderly patients avoid the negative consequences of polypharmacy by understanding how aging affects the body's reaction to medications, which drugs are the most problematic for older patients, and how to spot a drug-related problem and intervene.

Why elderly patients take so many meds

Several factors contribute to polypharmacy among patients over age 65. Clinicians may be prescribing more drugs for their elderly patients than they have in the past simply because there are more drugs available for treating these patients. The discovery of a broad range of pharmaceuticals for a wide variety of conditions has helped many patients. Unfortunately, this new development has also led to both overuse and inappropriate use of prescription medications.

Many drugs that were once obtainable only with a prescription, such as Prilosec (omeprazole) and Claritin (loratidine), are now readily available over the counter, and their use is on the rise. In addition, complementary and alternative medicines, such as herbal therapies, are becoming increasingly popular among all patients, including the elderly. (8)

Compared to the general population, a patient over 65 is more likely to have several chronic disorders, each requiring at least one medication. (9,10) Elderly patients with more than one health condition are likely to receive care from several healthcare providers, each of whom may prescribe a different medication to treat the same symptoms. (11)

Additionally, patients may purchase medications from more than one pharmacy, and each pharmacy checks for potential problems only on those medications that its pharmacist knows the patient is, or is supposed to be, taking. (11) Drug-related problems are less likely to occur when one physician or nurse practitioner oversees the patient's...

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Source Citation
Wooten, James, and Julie Galavis. "Polypharmacy: keeping the elderly safe: because they take more medications than younger patients, the elderly have a higher risk of adverse reactions. Here's how to help your older patients avoid trouble." RN, vol. 68, no. 8, Aug. 2005, pp. 44+. Accessed 8 Aug. 2022.

Gale Document Number: GALE|A135382030