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Unsafe medications are being prescribed routinely for individuals over age 65. A recent study examining prescription rates found that 1 in 5 older adults received at least 1 unsafe drug. Lead investigator Kevin A. Schulman, MD, of the Duke Clinical Research Institute said that, as the body ages, the way it reacts to medication changes, and the chance of severe side effects rises. Recently, attempts to steer the drugs most likely to produce these side effects away from older patients have included the publication of lists of drugs believed inappropriate for individuals over 65, according to Dr. Schulman.
The research involved comparing 1 of these lists with a database containing all prescriptions written in 1999 for 765,423 patients over 65 through a pharmaceutical benefit management company. The study indicated that 21% of the patients had at least 1 drug on the list, and that half of those prescriptions were for drugs considered to have the potential for serious side effects. Two antidepressants, amitriptyline and doxepin, were the most commonly prescribed inappropriate drugs. The results also showed that 15% of the patients had received 2 drugs from the list, and 4% had received 3 or more.
The list of drugs to avoid is not set in stone. Dr. Schulman said that in some cases a thorough evaluation by a physician would lead to the conclusion that a medication on the list would be the best option for a particular older patient. Yet, safer alternatives exist. The risks could be avoided if patients discussed medications with their physicians, he concluded.