Older people on medley of medicines risk life-threatening harm
About 2 million elderly people in the
Older people are being let down by a healthcare system that is allowing medicines to do more harm than good, according to a report from
More is not always better, said the report. Doctors tend to add new tablets each time an elderly person develops another health condition, but without stopping the old ones.
The more medicines elderly people take, the greater their risk of having a fall, which can put them in hospital. Nearly 1,000 older people a day are admitted to hospital because of falls, and their chance of falling again if they are over 65 goes up by 14% for every extra medicine they take over the first four, said the report.
Adverse drug reactions cause nearly 6% of unplanned hospital admissions, the report said. In one in 50 cases, the reaction is fatal.
Side-effects of medicines given to the elderly include nausea, dizziness, loss of appetite, low mood, weight loss, muscle weakness and delirium. As people get older, their ability to process medicines changes and they become more susceptible to side-effects. Opioid painkillers, for instance, should only be used at a quarter to half the normal dose.
Elderly people on various medications – known as polypharmacy – should have regular reviews of their drugs to ensure they are needed. The report tells of people struggling to cope with all the drugs they have been prescribed, such as 77-year-old Jane who is taking 17 medications, five of which have to be taken at least three times a day for a range of conditions including epilepsy, high blood pressure, hypothyroidism, COPD, osteoarthritis, psoriasis and vertigo.
Anne, 84 and living alone, is on 19 medications for conditions including ulcerative colitis, hypertension, asthma and osteoarthritis. She was discharged from hospital with three bags of medications but no record for her carers or the GP of what they were or when they should be taken.
“That’s why it is really important that a clinician, typically your GP, has a good overview of all your medicines and considers from time to time with you whether they are still the best for your health, not only on their own but when taken together with the other medications you are on.”
The medicines, however, have not been tested in trials in combination with other drugs or they might have been tested on 60-year-olds but not people over 70. “It is certainly something we need to take steps to tackle,” he said.
The report points out that non-drug treatments can also be tried. “Physical activity can help treat depression, lower blood pressure, reduce the amount of insulin someone with type 1 diabetes needs to manage their condition and even improve survival from breast and colon cancer.
“Also non-drug approaches like sensory therapy, massage, music and exercise may be more effective and safer than medicines for managing challenging behaviour in people with dementia,” it said.