According to new reports, America has another drug problem that often goes undiscussed: overprescribed seniors.
A recent article in the Washington Post highlighted the problem and the importance of coordinated care. The story focused on the inpatient geriatric unit at UCLA Medical Center in Santa Monica, Calif. The unit works to ensure that elderly patients aren’t overprescribed medications that could lead to adverse drug interactions.
One of the challenges as people age is that they may be treated for multiple chronic conditions, such as heart disease, diabetes, high blood pressure or high cholesterol. Some of the medications they are prescribed for these individual conditions might work well to treat the specific illness but in combination with other drugs it could to potentially life-threatening side effects.
The story highlighted several examples of these dangers. One 74-year old woman with high blood pressure and respiratory disease was taking 36 medications when she was admitted to the inpatient geriatric unit. Another 99-year-old woman had been prescribed high blood pressure medication that could cause her to fall or pass out. Another 84-year-old woman had been prescribed several medications that weren’t suitable for older patients because of their potential side effects.
The risk of overprescription is real — more than half of older patients’ hospital stays are caused by drug-related complications, according to Department of Health and Human Services’s research.
Mixing medication can lead to serious side effects, including low blood pressure, nausea, mobility and breathing issues in older patients. Coordinated care is essential for seniors. As we’ve previously written about on this blog, 77 percent of seniors have at least two chronic conditions. Seniors with these conditions must see several physicians — often at different locations — each with their own specializations. Because of this, patients often encounter poorly coordinated care.
As doctors, our goal is to do what’s in each patient’s best interest. Before prescribing a medication, it’s critical that a physician does a thorough review of your current medications and look for signs of possible adverse drug interactions. Patients also need to be completely honest about what medications they are taking and how often. It often helps if patients or their caregivers to come to the doctor with a detailed list of their current medications. This may reduce the risk of drug complications in the long run.
This also is why it’s so important for patients to see a geriatrician who can coordinate their care. At MetroHealth, we work with case managers, social workers, nurses, physical therapists and other specialists to ensure your medical needs are addressed. We also perform assessments that include a complete physical, comprehensive medical history and screening for chronic conditions, among other health services.
It’s critical for doctors to assess the risks and benefits of certain medications before they prescribe them. If something will do more harm than good, it’s best to not give it to a patient or to prescribe a drug that has fewer adverse side effects. The more doctors a patient sees, the more challenging it can be to avoid overprescribing, but coordinated care can solve this problem and keep seniors safe while ensuring they get the health care they need.
