Older Patient's At Risk From Dangerous Drug Combos

A nationwide survey suggests, nearly 2.2 million older Americans are at risk for serious health problems because they are popping dangerous drug combinations and non-prescription medications are commonly involved.

Over the past decade, older Americans’ use of over-the-counter medications (OTC), dietary supplements and prescription drugs has surged, writes researchers in the December 24 issue of the Journal of the American Medical Association.

"Older Americans’ use medicine and plenty of it," said Dr. Stacy Tessler Lindau of the University of Chicago Medical Center.

A recent study found U.S. adults over 65 made 175,000 emergency room visits a year due to adverse drug reactions. Widely prescribed drugs accounted for a third of those visits.

“Many are under the false assumption that non-prescription drugs and supplements are safer than prescription drugs,” says co-author Dima Qato, a pharmacist at the University of Chicago Medical Center.

The study, led by Lindau and Qato is based on data from a national survey of that focused on adults aged 57 to 85 and interviews with about 3,000 people in their homes to determine the drugs they used on a regular basis.

They examined possible interactions among 20 popular prescription, dietary supplements and over-the-counter drugs and found about 68 percent of adults surveyed who used prescription drugs also took dietary supplements and/or over-the-counter drugs.

For instance, some study participants were taking warafin (blood thinner) with simvastatin (cholesterol-lowering drug), a combination known to increase the risk of bleeding. Others were taking aspirin and warfarin together, which can also lead to serious health problems.

Nearly 30 percent of surveyors regularly take five prescription drugs, a higher proportion compared to a decade ago wrote Qato and co-authors. And 40 percent used one or more over-the-counter drugs. The most frequently used over-the-counter and prescription drugs were used to treat heart disease. They ranged from statins to aspirin to blood thinning agents.

The most common dietary supplements were multivitamins, single vitamins and minerals, but alternative therapies thought to improve heart health, such as garlic and omeg-3 fatty acids were also common.

The findings have implications for the Food and Drug Administration, policymakers, patients, pharmacists and physicians. "Everyone needs to do what they can to improve safety in older adults," says Qato.

Amy Ehrlich, head of the geriatrics fellowship program at Montefiore Medical Center in New York, advises her patients to bring along all of the medications they take regularly when they come in for a visit, especially because many patients see multiple doctors. Drug interaction issues, says Elrich, “comes up on a daily basis… with every single patient.” #