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Every day, 750 older Americans are hospitalized due to serious side effects from one or more medications.
The odds of experiencing a serious adverse reaction to a medication increase 7-10% with each additional drug — yet today, more than 40% of older Americans regularly take five or more prescription drugs, and nearly 20% take more than 10 medications.
When over-the-counter meds are included, a full two-thirds of older adults take five or more medications.
If current trends continue, over the next decade there will be more than 4.5 million hospitalizations of older adults for serious side effects of medications, predicts the Lown Institute, a Massachusetts-based, nonpartisan healthcare “think tank.”
To stem the tide of harm, the Lown Institute recently released “Eliminating Medication Overload: A National Action Plan.”
The plan was developed by a group of 22 experts in medication use, including patient advocates, physicians, nurses, pharmacists, and researchers from the U.S. and Canada. Eleven additional experts served on an advisory board.
“A lot of attention is currently focused on the cost of medications,” says Shannon Brownlee, senior vice president of the Lown Institute and co-author of last April’s report, “Medication Overload: America’s Other Drug Problem,” which laid out the scope of medication-related harm.
“The most costly medications are those that are not needed or are causing harm. Over the next decade, the U.S. is on track to spend $62 billion on unnecessary hospitalizations caused by too many meds. More importantly, medication harm will lead to the premature death of more than 150,000 older Americans.”
“Eliminating Medication Overload” recommends five high-level action areas:
1. Implement prescription checkups: Patients using multiple medications need regular prescription checkups — visits where they review all their medications with their primary care provider and identify unnecessary or potentially harmful meds that can be safely deprescribed (discontinued or reduced in dose).
2. Raise awareness among clinicians, policymakers, and the public: Targeted campaigns as well as larger, mass-appeal efforts to raise awareness would encourage patients to “ask their doctors” if medications are wrong for them.
3. Improve information at the point of care: Healthcare providers do not always have clear, accurate, up-to-date information on the harms and benefits of medications when making prescribing decisions, nor do they necessarily have a full list of the medications their patients are taking — and for what reason.
Improving clinical guidelines and electronic health records are two essential actions.
4. Educate and train health professionals to reduce medication overload: Healthcare professionals are reluctant to deprescribe because they have insufficient training in this area.
In professional schools and continuing education, curricula must be adapted to an older population, with greater emphasis on the potential harm of medication overload for older adults.
5. Reduce the influence of the pharmaceutical industry: Though there have been amazing breakthroughs in pharmacological treatments, direct-to-consumer advertising of drugs and drug rep visits to physician offices overemphasize the potential benefits while downplaying side effects.
Regulatory action is needed to ensure advertising and marketing provide accurate information related to medication use, particularly for older patients.
“Medication helps many older people make the most of increased longevity, but that can only happen when all of our treatments are optimized to be used safely and to meet our personal needs,” says Sunny Linnebur, Pharm.D., president of the American Geriatrics Society, which affirmed the value of the action plan.
For more information on the report, visit https://lowninstitute.org or call the Lown Institute at (617) 992-9322.