Problems with medicine use in older Australians: a review of recent literature

Rohan Andrew Elliott, Jane C Booth

Research output: Contribution to journalArticleResearchpeer-review

35 Citations (Scopus)

Abstract

Abstract: Older people are at increased risk of medication-related problems and adverse medication events. This paper reviews literature on problems with medicine use in older Australians published between 2006 and 2013. The prevalence of polypharmacy has continued to rise. Polypharmacy, multiple comorbidities and inappropriate prescribing have been linked to drug?drug and drug?disease interactions and medicine-related hospitalisations. Inaccurate medication histories, suboptimal continuity of medication management, complex medication regimens and non-adherence have been reported. Studies describing medication reviews, usually conducted by pharmacists, indicate that older people taking multiple medicines have an average of one to three current medication-related problems, including inappropriate or unnecessary medicines, untreated indications, suboptimal monitoring andadverse drug reactions. These findings indicate that problems with medicine use and adverse medication events remain highly prevalent in older Australians, despite the introduction of a range of quality use of medicines strategies. This may be due to a range of factors such as increasing intensity and complexity of medical therapy, and suboptimal uptake and /or targeting of quality use of medicines strategies. In settings where quality use of medicines strategies have been implemented, there is evidence for improved prescribing and, in some situations, reduced adverse events. Problems with medicine use in older people remain a major challenge to the Australian healthcare system: polypharmacy may be unavoidable in people with multiple comorbidities, so there needs to be a focus on managing and reducing the risks associated with polypharmacy.
Original languageEnglish
Pages (from-to)258-271
Number of pages14
JournalJournal of Pharmacy Practice and Research
Volume44
Issue number4
DOIs
Publication statusPublished - 2014

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