Around one million Australians over the age of 70 may be taking too many medications every day.
And for many, that can result in falls, confusion, hospitalisation and even death.
That’s the warning from the University of South Australia, which is aiming to reduce the number of inappropriate medications prescribed for older Australians.
This worldwide problem, known as ‘polypharmacy’, has been described by the World Health Organisation (WHO) as one of the major challenges facing society.
It’s a problem well known to many YourLifeChoices members. One member told us: “Until about 18 months ago, I was taking eight prescribed medications plus five supplements on the advice of doctors, plus periodically being prescribed heavy duty painkillers in addition to the regular painkillers that I had to take every day.
“In spite of continual requests to review all the medications, every doctor I asked simply looked at the list and said they all looked okay and to keep taking them.
“Eventually I became very ill and at that point conducted my own personal revolution. I threw out all the medications and waited to see what would happen.”
This member reported a very positive outcome but that approach is not something YourLifeChoices would recommend.
The member added: “I think we may have become conditioned to just accept whatever we are told by professionals who may, or may not, have our overall health situation clearly in front of them when prescribing.”
University of South Australia researcher Dr Emily Reeve says despite widespread evidence showing the harm that inappropriate medications are causing to older Australians, current guidelines provide few, if any, recommendations for clinicians about when, or how, to stop medications.
“A typical older Australian has four chronic health conditions and is taking six regular medications, one of which is inappropriate, with the potential harm outweighing any benefits,” she says.
“Withdrawing inappropriate medication may seem straightforward, but it’s not. It’s complex, due to a lack of evidence-based guidelines based on robust and internationally recognised methodology.”
A joint University of Western Australia and University of NSW study found that the number of older people taking five or more medicines had increased by 52 per cent between 2006 and 2017, despite evidence that this puts patients at risk of harm and is associated with poor clinical outcomes.
Dr Reeve says that in addition to the health risks, polypharmacy is a huge financial burden for global health systems. In Australia, hundreds of millions of dollars are wasted annually through the prescribing of inappropriate medications, she says. Worldwide, the WHO estimates that $18 billion could be saved by correctly managing medication use.
“The economic benefits of de-prescribing means that governments can direct those savings towards other quality use of medicines and non-drug treatments,” Dr Reeve says.
“The feedback from clinicians is that the lack of guidelines not only limits de-prescription, but it also influences the culture of medicine, suggesting that withdrawing medicines is not as important as prescribing them in the first place.”
Using a $1.5 million federal government grant, Dr Reeve intends to spend the next five years establishing guidelines, testing their implementation in aged care facilities and measuring their effectiveness.
“In residential aged care homes in Australia, inappropriate medications account for around 20 per cent of prescription costs,” Dr Reeve says. “We have an opportunity here to address that issue and redirect that money on high value care instead.”
Another member told YourLifeChoices how her mother’s medications increased after she had had a fall.
“She had her own medication by her own doctor. More medication was added in hospital. She went to a nursing home for respite care and, needless to say, more medication was added.
“When she went home, she had 20 types of medication. This situation must be better managed.”
In YourLifeChoices’ 2019 Retirement Matters survey, 79 per cent of the almost 4500 respondents said they took ongoing prescription medications. The most common were for blood pressure problems, followed by arthritis and heart disease.
Are you taking regular medications? Has the number grown as you have aged?
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Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.
