Inappropriate Prescriptions for Elderly Pose Serious Health Risk: Group

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By: Irvin Jackson | Published: March 18th, 2013

The prominent consumer watchdog group Public Citizen is warning about the continuing dangers associated with inappropriate prescription drugs that are commonly given to elderly patients. 

In the most recent issue of Public Citizen’s Worst Pills, Best Pills newsletter, the group highlights the risks that come with misprescribing drugs to older patients, calling it a dangerous and persistent problem in the United States and around the world.

“In the U.S. alone, misprescribing ultimately leads to millions of preventable adverse events and more than 100,000 deaths annually,” the group notes in the newsletter. “It wastes billions of dollars within our health care system.”

The newsletter points to a study published last year that found that about 20% of prescriptions for elderly patients in a primary care setting, like a nursing home, were inappropriate over the last 15 years.

The most commonly misprescribed drug was propoxyphene, a painkiller that was removed from the market in 2010. The second most commonly misprescribed drug is Cardura, a blood pressure medication that some studies have found to have higher risks than similar drugs, but is less effective.

The other most commonly misprescribed drugs for elderly patients are Benadryl and amitriptyline-based antidepressants like Elavil, Tryptomer, Tryptizol and Saroten.

“Such misprescribing typically occurs when a doctor prescribes a drug even when it is contraindicated because of a patient’s age, underlying medical condition or use of other drugs, or when the prescribed dose is too high or the prescribed duration of use is too long,” according to the Public Citizen newsletter. “In many cases, especially in the elderly, prescribing is inappropriate because safer alternatives, either other drugs or nondrug interventions, are available.”

Concerns Over Antipsychotic Drug Prescriptions for Elderly

Last year also saw increasing concern over the use of antipsychotic drugs for the treatment of dementia among older patients. Some experts have suggested that such drugs have been increasingly used in many nursing homes as a form of chemical restraint. Other concerns have been raised that use of the medications may increase the risk of falls and deaths, without providing any benefit to the patient.

In May 2012, a special report by the Boston Globe found that about 185,000 nursing home residents nationwide were prescribed antipsychotic medications in 2010, even though they had none of the conditions for which the drugs had been approved to treat.

The widespread overuse of antipsychotic medications, such as Risperdal, Seroquel, Zyprexa and Abilify, continues despite warnings issued by the FDA and other health experts indicating that the drugs should not to be used to treat patients with Alzheimer’s disease and dementia, because they may increase the risk of death for individuals with those conditions.

Part of a class of medications known as atypical antipsychotics, the drugs are approved to treat a number of mental health problems, such as bipolar disorder and schizophrenia.  However, they are also widely used “off-label” for ailments that have not been approved by the FDA, because the manufacturers have not established that they are safe or effective for those conditions.

Nursing home officials have suggested that they are giving the drugs to some elderly residents to prevent them from harming themselves and others, but health experts say that the drugs place the elderly residents in a stupor, increasing the risk of nursing home falls and other problems.  The chemical restraints also lower their quality of life by leaving them in a perpetual state of mind-numbed sedation, causing many to consider the use of the drugs in these situations to be a form of nursing home abuse.

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