One in Five Seniors Prescribed Incorrect Medication, Study Says
About one in five seniors has been "inappropriately" prescribed drugs such as antidepressants and tranquilizers "that can leave them dazed, groggy or susceptible to falls," according to a study appearing in the Dec. 12 issue of the Journal of the American Medical Association. Reuters/Contra Costa Times reports that, according to the study, an estimated seven million Americans ages 65 and older in 1996 were prescribed at least one of 33 drugs deemed inappropriate for use by seniors because of possible side effects (Reuters/Contra Costa Times, 12/11). In the study, researchers led by Dr. Chunliu Zhan of the Agency for Healthcare Research and Quality analyzed the 1996 Medical Expenditure Panel Survey, which contained responses from 2,455 seniors. The researchers convened a panel of seven experts to categorize which medications are inappropriate for seniors. In 1996, 21.3% of "community-dwelling" seniors -- those not in institutions such as hospitals or nursing homes -- were prescribed an inappropriate medication. Based on the panel's classification, the study determined that 2.6% of seniors used at least one of the 11 drugs, including barbiturates, that "should always be avoided by elderly patients"; 9.1% used at least one of the eight drugs that "would rarely be appropriate"; and 13.3% used at least one of the 14 drugs "that have some [benefits] but are often misused." Researchers found that the overall rate of inappropriate medication use had declined since 1987, when a similar study determined the rate as 23.5%. Still, the authors of the new study concluded that "overall inappropriate medication use in elderly patients remains a serious problem" (Zhan et al., JAMA, 12/12).
A Growing Problem?
According to the study's authors, the problem of inappropriate use could grow if Congress enacts a Medicare prescription drug benefit, which would make medications more accessible to seniors. The authors say that educational measures for physicians and patients are needed to stem the problem. In an accompanying editorial, Dr. Jerry Avorn of Harvard Medical School wrote: "Elderly patients are falling and sustaining hip fractures because of the overuse and misuse of a wide variety of more modern agents, even those short half-life tranquilizers and hypnotics that would never make it onto any most wanted list of inappropriate drugs. Some patients are being labeled with diagnoses of new illnesses, or are simply viewed as 'just getting old' when they manifest adverse effects of anti-psychotic drugs used to excess" (Reuters/Contra Costa Times, 12/11). The study is available online.
