Piling On the Pills

As people age, their list of medications tends to grow. But new research shows that many of the drugs older adults take are inappropriately prescribed—and could be harmful.

According to a University at Buffalo-led study, the prescription of potentially inappropriate medications to older adults costs patients more than $450 per year on average, almost doubles their chance of hospitalization, and is widespread. Among the 218 million-plus older adults surveyed in the study, more than 34% were prescribed at least one of these problematic drugs.

As the human body ages, the risk of harmful side effects from medications increases. Drugs can be considered potentially inappropriate when the risks they pose outweigh the potential benefits, or when effective but lower-risk alternative treatments are available. When it comes to older adults, potentially inappropriate medications encompass everything from antidepressants, barbiturates and antipsychotics to common pain relievers and antihistamines.

In the study, older adults taking at least one of these medications were, on average, prescribed twice as many drugs, were nearly twice as likely to be hospitalized or visit the ER, and were more likely to visit a primary care physician compared to those who were not prescribed potentially inappropriate medication.

Evaluation of patients’ medications—and cutting them back when advisable—needs to be a public health priority, say the researchers.

“Deprescribing is currently at an early stage in the United States,” says David Jacobs, assistant professor of pharmacy practice at UB and lead investigator on the study. “Further work is needed to implement interventions that target unnecessary and inappropriate medications in older adults.”

To that end, Jacobs and others on the research team are part of UB’s Team Alice, an initiative of the university’s Center for Successful Aging that promotes deprescribing efforts through research, education and advocacy. UB faculty member Mary Brennan-Taylor co-founded the initiative after her mother, Alice Brennan, suffered an untimely death as a result of preventable medication errors and system failure.