MILLIONS of older people in the UK are on seven or more prescription medications and at risk of side effects that could be severe or life-threatening, campaigners have warned.
A report by Age UK said too many older people are on too many prescribed medicines– known as polypharmacy – putting them at risk of side effects that in many cases can lead to falls and a range of other serious harms.
The report said between 2008 and 2015 the number of emergency hospital admissions in England and Wales caused by adverse drug reactions increased by 53 per cent and in one in 50 cases that reaction proved to be fatal.
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There was no specific data for Scotland, but the figure ties in with a previous report from the Royal Pharmaceutical Society (RPS) in Scotland highlighting that about 61,000 non-elective hospital admissions every year were due to people not taking medications as prescribed.
About two million people in England and Wales are on seven or more medications, while in Scotland – where polypharmacy is counted as 10 or more medications – there are nearly 43,000 people over the age of 65 who are on 10 or more drugs for multiple conditions.
Of these, 7070 are in care homes and 8,190 have dementia.
Overall, 26% of people in Scotland who are aged 80 and older are on 10 or more different drugs.
The More Harm Than Good report suggests that prescribing more drugs is not always the best option, particularly for older people.
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It said medicines are sometimes being prescribed in excessive numbers, in unsafe combinations, without the consent or involvement of the older people concerned and without the support and help older people need to take them.
Complications can occur when different drugs interact together in ways that cause patients to fall ill or become disoriented, or when patients on multiple drugs accidentally skip or consume too many.
Brian Sloan, chief executive of Age Scotland, said: “We’re fortunate so many effective drug treatments are available, and these can be essential to many older people’s health and wellbeing. But it’s worrying that in some cases, the risks can start to outweigh the benefits.
“About one in 10 unplanned hospital admissions is caused by harm from medicines, and these are far more common in older people.
“It’s not unusual for older people to take 10 or more medicines to manage multiple conditions. While in most cases these are medically necessary, this does increase the risk of adverse affects and hospital admissions.
“Getting the right balance can be especially challenging in care homes, where residents are typically coping with a number of health issues. Over-prescribing is a very real concern, and can have a really damaging impact on older people’s lives.”
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The charity said people should never stop taking any medications of their own accord.
Mr Sloan said: “It’s vital doctors conduct regular reviews of patients taking multiple medicines, especially those who are frailest or taking high-risk drugs.
"We would never advise anyone to stop taking a medicine without their doctor’s advice. But if you are concerned about yourself or someone else, it’s important you speak to your GP and ask for a review.”
According to the Scottish Government data, up to 11% of unplanned hospital admissions in Scotland are caused by harm from medicines. More than 70% of these are among older people.
Part of the new GP contract for Scotland includes plans to base a pharmacist in all GP practices to review patients on multiple drugs. There is also evidence that embedding pharmacists in care homes reduces falls.
Aileen Bryson, deputy director of RPS Scotland, said: “In care homes that have dedicated pharmacist support there is already emerging evidence that medication reviews are leading to reductions in inappropriate polypharmacy, improved quality of life for residents, reduced unplanned admissions to hospital and better training and education of care home staff.
“Care home residents fall on average two to six times a year and many medicines are implicated in increasing risk of falls. Pharmacist-led medication reviews have been shown to lead to a reduction in the number of falls.”
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