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Many Older Adults Take Potentially Inappropriate Medications and Use Medication Pillboxes Incorrectly, Find Studies Presented at American Geriatrics Society's 2007 Annual Scientific Meeting

Seattle, WA - A significant number of older adults who take multiple drugs may be taking potentially inappropriate medications and experiencing adverse drug reactions as a result of "polypharmacy" (taking many medications), according to a study presented here on May 3 at the American Geriatrics Society's 2007 Annual Scientific Meeting. Further boosting risks of such reactions, many older adults don't use pillboxes correctly, according to a second study that will be presented on May 4 at the meeting, the premier conference on aging research.

Because older adults are more likely than younger adults to have multiple health problems and to take multiple medications, and because medications can interact, older people run increased risks of taking potentially inappropriate medications, taking medications incorrectly, and having adverse drug reactions.

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Researchers conducting the first study questioned 124 older adults who were treated at a tertiary care hospital Emergency Department (ED) about the medications they took. The researchers used a standard questionnaire developed to evaluate medication use in older people. On average, the adults were taking 8 different medications, the researchers found. More than 30% were taking at least one potentially inappropriate medication that had been prescribed prior to their visit to the ED. Another 6% had been prescribed a potentially inappropriate medication while at the ED. Potential adverse drug events meeting the research criteria were found in 27% of subjects, according to lead researcher Neil Nixdorff of the Case Western Reserve University School of Medicine and his colleagues with the Cleveland Clinic Section of Geriatric Medicine and the Department of Emergency Medicine. The study results were presented during AGS' Annual Scientific Meeting by research assistant Anna Brady, a second-year medical student at the Cleveland Clinic Lerner College of Medicine.

Given these findings "screening for potentially inappropriate medication use, as well as a study of predictors of this use, may be warranted," the researchers conclude.

"We have taken these findings seriously and are incorporating them into teaching tools at three sites of care for elders: the emergency department, the geriatric assessment clinic, and the nursing home," said Barbara J. Messinger-Rapport, MD, Ph.D., co-presenter and program director for the Geriatric Medicine Fellowship program at the Cleveland Clinic. "We think they will contribute to better patient safety and hopefully to careful medication pruning."

In the second study, researchers at Mount Allison University in New Brunswick surveyed 378 older adults, asking about their use of pillboxes and other devices intended to help those who take multiple medications do so appropriately.

Of the 136 adults who completed the surveys, 99 used pill boxes, but few used them as recommended, report the researchers. More than 79% failed to use pillboxes that have multiple compartments for each day's medication - the type that healthcare providers recommend. In addition, about 94% of those who used pillboxes reported that they put their medications in their pillboxes themselves, but rarely or never had anyone else check whether they'd made errors while filling the boxes. In addition, more than 76% of older adults using the boxes said they didn't refer to written directions or medication labels to remind themselves of their medication regimens when filling their boxes.

"Although pillboxes are often recommended and widely used, the types of pillboxes chosen and the ways they are used may not be optimal to ensure adherence," conclude the researchers, Odette Gould and Laura Todd.

ABOUT THE AGS

Founded in 1942, the American Geriatrics Society (www.americangeriatrics.org) is a nationwide, not-for-profit association of geriatrics health care professionals dedicated to improving the health, independence, and quality of life of all older people. The Society supports this mission through activities in clinical practice, professional and public education, research, and public policy. With an active membership of over 6,700 health care professionals, the Society has become a pivotal force in shaping attitudes, policies, and practices in geriatric medicine.