Seniors are the largest consumers of both prescription and over-the-counter medications. According to a study published in the Journal of the American Medical Association, one in three Americans over the age of 65 takes five or more prescription medications. The typical 75-year-old takes more than 10 prescription drugs. And while these drugs have helped save lives and improve the health and well-being of millions of people, overmedicated seniors have developed life-threatening side effects. A recent study found approximately one in five prescriptions written for elderly patients was inappropriate.
The Harm of Overmedication
According to an article published in the New England Journal of Medicine, there were an estimated 99,628 emergency hospitalizations annually for adverse drug events in individuals 65 years and older for the years 2007 to 2009. Most of these hospitalizations resulted from commonly used medications and not from drugs considered high-risk or inappropriate. Overmedication of seniors has been linked to falls, kidney failure and even heart attacks as well as misdiagnoses for conditions from depression to dementia. One-third of prescription-related deaths are of elderly persons.
Why it Happens
There are numerous reasons why overmedication happens, ranging from a lack of communication among a person’s various healthcare providers to trying to treat multiple health conditions at once. Here are some of the most common causes of overmedication.
Adverse reactions mistaken for a new symptom
Part of the problem may lie in the fact that doctors often treat a new symptom with another drug instead of seeing the symptom for what it is – an adverse reaction to a current drug. That’s what happened to an 83-year-old grandmother whose story was reported in the Washington Post. She was hospitalized for an asthma attack. In the hospital she was prescribed steroids for the asthma. This made her blood pressure skyrocket, which caused vertigo. So she was prescribed a blood pressure medication, which made her dizzy. Then her ankles began to swell, so she was given a water pill, which caused her potassium levels to drop. Additionally, she was given a drug to treat osteoporosis, which eventually lead to gastric bleeding. Doctors will frequently see the adverse reaction as a new disease instead of a side effect and prescribe a new medication to handle the new symptom, increasing the possibility of adverse reactions to a drug that isn’t needed. Dr. Michael W. Rich, a cardiology professor at Washington University says, “The likelihood of an adverse reaction for someone taking more than 10 prescription drugs is nearly 100 percent.”
Erring on the Side of Caution
Adding to the problem is the fact that many doctors often take the “better safe than sorry” approach when prescribing medications. For instance, statin drugs – used to treat high cholesterol – are one of the most-prescribed drugs in the U.S., and seniors are likely targets for the medication. The rate of statin use among people age 80 and older – who have no history of heart disease or stroke – increased four times from 1999 through 2012, according to two researchers from Ohio State University and the University of Alberta, making the elderly the highest users of statins in the U.S. The problem here is that for patients this old, there is little to no research demonstrating that the benefits outweigh the risks, which can including muscle pain, liver damage and an increased risk of developing diabetes.
A vulnerable population
Finally, one of the reasons elders are overmedicated may be due to the fact that elders are a vulnerable population. Seniors are more likely to have memory loss and get confused easily. Seniors are notorious for not questioning their doctors and often, they see more than one doctor without sharing this information, so the left hand doesn’t know what the right hand is doing.
How to protect yourself or someone you love
Before any appointment with a medical professional, you should make a list of all the medications and dosage directions – including over-the-counter ones – you or a loved one is taking. Show the list to your doctor and ask specifically about contraindications with other medications. Make sure all the dosages are still appropriate. If you don’t know what a particular medication is for, ask! Whenever your doctor prescribes a new drug, ask what it’s for and if you really need it. Get educated on all the possible side effects of any medication you’re taking. If your doctor gives you a medication for high blood pressure and high blood pressure is a side effect of another medication, point this out and get the right combination of drugs that will best suit your specific situation. A care manager can help in serving as a single point of contact among all your healthcare providers to help ensure you’re getting only the medications you really need.
Finally, be an advocate for yourself or enlist of the help of a care manager to advocate for you. Don’t be afraid to ask questions. If a medication is making you sick, ask your doctor for an alternative therapy or treatment. You know your own body better than anyone else and you have the right to live as comfortably as possible, even while on medication.
