Older adults are consuming more and more prescription drugs. Over half of these drugs are not taken correctly or are prescribed to them by physicians in an excessive manner. There is accumulating evidence showing that drugs prescribed to the elderly can not only contribute to an inefficient use of health resources, they are potentially dangerous to people.
A recent CIHI report shows that roughly two out of three seniors (66 percent) on public drug programs in Canada had claims for 5 or more drug classes in 2012. One in four seniors (27 percent) had claims for 10 or more. This is more than three years earlier (63 percent and 23 percent).
Is that effectively contributing to better health and well-being among older adults?
The problem is that polypharmacy – using five or more medications – increases the risks of drug interactions. In some cases, multiple medications may not work well together.
Because of the lowered renal and liver function associated with advanced age, seniors are especially at risk for adverse medication reactions such as unsteadiness and confusion, delirium and increased levels of depression. And as seniors are excluded from most clinical trials, evidence on treating them safely and efficiently with medication is often deficient.
A 2012 study indicates that among Canadian seniors taking five or more medications, 12 percent will experience a side effect requiring medical attention. This is a risk more than twice higher than for those who take only one or two prescriptions. The more prescribed drugs a senior person takes, the more likely this person is to use the hospital emergency department. This applies even when controlling for age and number of chronic conditions.
In his 2010 Report, Canada’s Chief Public Health Officer indicates that 20 percent of hospitalizations for people age 50 and over was due to their medication.
While doctors, pharmacists and other health professionals are increasingly aware of these issues, evidence indicates that effective solutions are needed. Authorities are responsible for ensuring the patients’ safety. Governments are responsible for properly managing our collective resources.
With the rapid aging of their populations, Canadian governments need to address this in a sensible way if they want to ensure not only a sustainable health care system, but also the safety of senior patients. It is time they take a close look at this and start investigating possible solutions reaching well beyond clinical practices.