Older people are more likely to take a variety of medications to manage multiple chronic health issues such as hypertension, diabetes, arthritis, Alzheimer’s disease, pain and other conditions related to aging.
“Patients age 65 and older make up 15 percent of the U.S. population, but they account for half of the hospital readmissions due to medication side effects,” said
Sarah Lorentz, PharmD, director of medication therapy management services at Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego.
Because older people take more drugs, their risk of adverse side effects is higher. The most common problems include:
Side effects that affect thinking and balance: This can increase the risk of falls or cause confusion. Common drugs include:
- Anticholindergics for conditions such as urinary incontinence, overactive bladder and chronic obstructive pulmonary disorder (COPD)
- Sedatives and tranquilizers such as zolpidem (Ambien) and lorazepam (Ativan)
Symptoms that persist despite drug treatment: Sometimes older patients are started on a drug for a symptom or condition but do not follow up with their doctor to see if they still need the drug or if the dose should be adjusted.
Drug interactions: Some drugs tend to affect other medications, such as the blood thinner warfarin, which can affect with antibiotics and other drugs.
Dosage is too high: Older people can be more sensitive to a drug and might need a lower dose. Examples include blood pressure medications that might result in lightheadedness (which could increase falls) and diabetes drugs that cause low blood sugar episodes (a common cause of medication-related hospitalizations).
Complicated scheduling: Many older adults need to take several pills at different times of the day with or without food. This can get burdensome and cause patients to skip medications.
Cost: Some people might avoid medications due to financial burden. Even with drug coverage provided by Medicare Part D, the monthly costs can be high.
Since many seniors see multiple doctors, they can be confused about their medication, especially after a hospital stay, when they are often prescribed even more medications.
“This is especially true during transitions of care, when a patient moves from a hospital to home or to a care facility,” says Lorentz.
Lorentz advises patients or caregivers to make a comprehensive list of all medications, including prescription drugs, over-the-counter drugs, vitamins and herbal supplements. The list should be on hand for medical appointments and trips to the pharmacy.
“Major health systems such as UC San Diego Health employ pharmacists who are more likely to have additional training in geriatrics and other specialty areas of pharmacy, but the most helpful way to manage your medication is to use the same pharmacy consistently,” she said. “They will have your information on file and can catch potential adverse interactions.”
Did you know?
The Gary and Mary West Emergency Department at UC San Diego Health in La Jolla is one of just a few in the nation to be accredited as a geriatric emergency department by the American College of Emergency Physicians (ACEP).
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