Copy of 1 in 3 Americans Prescribed Inappropriate Drugs

THURSDAY, Oct. 29, 2020 – More than one-third of older Americans are prescribed drugs they may not need, a new study finds.

In fact, these patients are prescribed twice as many drugs as needed and are nearly twice as likely to be hospitalized or wind up in the emergency department. On average, they pay more than $450 a year in extra health care costs, the researchers said.
“Inappropriate prescribing to older adults can have significant adverse clinical and financial impact,” said Collin Clark, a clinical assistant professor at the University at Buffalo School of Pharmacy and Pharmaceutical Science, in New York.
“As the age of the U.S. population continues to rise, use of potentially inappropriate medications in this population will continue to be a public health challenge,” he added.

The most likely drugs to be inappropriately prescribed included first-generation antihistamines like diphenhydramine; antipsychotics like haloperidol, risperidone or olanzapine; benzodiazepines like diazepam (Valium); nonsteroidal anti-inflammatory drugs (NSAIDs); proton pump inhibitors; and long-acting sulfonylureas like glyburide, said Dr. Maria Torroella Carney, chief of the division of geriatric and palliative medicine at Northwell Health in New Hyde Park, N.Y. She was not involved in the study.
Among more than 218 million older adults who took part in a survey conducted by the U.S. Public Health Service and the U.S. Centers for Disease Control and Prevention, the researchers found that 34% were prescribed at least one potentially inappropriate drug.

Carney said that patients most likely to be prescribed inappropriate medications are those who believe they are not in good health, compared with others their age.

“Because the patients that had more potentially inappropriate medications prescribed thought their health was not as good as others, that may explain why they sought out care and treatment,” she suggested.

Some of the factors contributing to prescribing of potentially inappropriate medications are the need of doctors to offer help, the demand from patients for something to help, and a doctor’s lack of awareness of medications’ effects and risks on older adults, Carney said. “Also, doctors are not informed about or have access to other options to assist older adult patients in their care,” she added.

These inappropriate medications can cost extra, but they are likely covered by insurance and not as costly to patients, as opposed to non-pharmacologic treatments, which are often not covered by insurance, Carney noted.
When prescribing medications, the risks and benefits need to be weighed. Medications with a good safety profile that are not long-acting should be tried first and explained to patients and their families, she said.

“As clinicians, we need to try alternative treatment options first and try to minimize pharmacologic intervention when and where we are able to do so,” Carney said.

The report was published recently in the Journal of the American Geriatrics Society.

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