Seniors Often Prescribed Risky Medications

Research reveals that physicians in the United States routinely prescribe dangerous drugs to the elderly, especially in southern states.

The emerging study revealed that more than one in five seniors covered under Medicare in the South received medication prescriptions that, say health authorities, should not be prescribed to older patients due to the drugs’ significant side effects, said The New York Times. Looking at people aged 65 years and older and comparing New England and Southern residents (Texas to South Carolina), the southern senior demographic was 12 percent likelier to be prescribed a high-risk drug.

The research team believed that issues including education, socioeconomic standing, and quality health care access could be behind the regional disparity, and, in part, that was the case. For instance, the lower the socioeconomic status, the greater the chance that a senior would be prescribed a high-risk medication, said The Times. Yet, the researchers found that the disparity continued even after accounting for these factors.

“We can’t specifically identify the reason the southern states have these rates that are so much higher,” Dr. Amal Trivedi, study author and an assistant professor of health services, policy, and practice at Brown University’s Alpert Medical School, told The Times. “But I think it’s important for physicians and patients to be aware of it.” The findings were published in the recent issue of The Journal of General Internal Medicine.

The researchers utilized a list of 110 drugs to avoid in the senior population and reviewed data on more than six million seniors nationwide enrolled in Medicare Advantage plans; the National Committee for Quality Assurance compiled the list, said The Times. The drugs presented greater risks in older patients, though broadly used with minimal adverse reactions in younger patients, explained The Times. Drugs included anti-anxiety medications, which may be difficult for the elderly to metabolize. The drugs, said The Times, remain in the patient’s system, creating longer periods of sedation, which can lead to increased likelihoods for falls and fractures and, even, addiction, said lead study author Danya Qato, pharmacist and doctoral candidate in health services research at Brown. Some muscle relaxants and diabetes drugs may also remain in older patients’ systems longer, increasing complications rates.

“We started this study because we know that these medications are likely to have more harms than benefits in older patients,” Dr. Trivedi told The Times. “We have tried to reduce the use of these medications, and it’s important to figure out exactly how common they are among the elderly and what types of factors contribute to their use.” Some 1.3 million of the seniors studied had been prescribed at least one high-risk drug in 2009, despite that there were often safer options; 5 percent studied had been prescribed at least two high-risk drugs, said The Times.

On a related issue, we previously wrote that the Centers for Medicare and Medicaid Services (CMS)  was hoping to curb the use of antipsychotic medications in nursing homes, a growing and dangerous issue on which we have long been writing. As we’ve said, there are dangers in the needless dosing of the elderly with antidepressants, antipsychotics, and sedatives, which are sometimes given for seemingly pointless reasons and appear to be linked to falls, other accidents in the elderly, and death.

Antipsychotics are being used, off-label, in nursing homes to treat a host of unapproved diagnoses, including dementia. There are no drugs currently approved by the U.S. Food & Drug Administration (FDA) to manage agitation, aggression, and hallucinations in the elderly and those diagnosed with Alzheimer’s disease and dementia. Risks include diabetes, movement disorders that can become permanent, pneumonia, stroke, weight gain, and sudden cardiac death.

According to the CMS, the rising practice of unnecessarily treating the elderly with antipsychotics represents a significant change in how dementia care is handled. The FDA states that antipsychotics can lead to dizziness, sudden blood pressure drops, abnormal heart rhythm, blurred vision, and urinary problems in dementia patients. Yet, prior reports found that more than one in five U.S. nursing homes administered antipsychotics to people with no diagnosis for a condition warranting use of the drugs. In fact, in 2010, some 185,000 U.S. nursing home residents received antipsychotics even though prescribing these drugs went against federal nursing home regulator recommendations. Many were suffering from Alzheimer’s disease or some other dementia-related disorder despite that antipsychotics are intended for people diagnosed with schizophrenia.

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