When Medications Counteract Each Other in Seniors

Here’s an alarming headline: One-fifth of older Americans receive medications that may adversely affect coexisting conditions, according to a new study conducted by researchers from Oregon State University and the Yale University School of Medicine. In fact, Jonathan Lorgunpai, a medical student at the Yale School of Medicine and co-author of the study, warned, “More than 9 million older adults in the U.S. are being prescribed medications that may be causing them more harm than benefit.”

Senior Care Pharmacy Facts

Adverse drug reactions are among the top five greatest threats to the health of seniors.

Seniors have more chronic diseases and multiple conditions, so they use more prescription and over-the-counter drugs. More than 77% of seniors between the ages of 65 and 79 suffer from one or more chronic diseases. The number rises to 85% for those over age 80.

  • Seniors represent just over 13% of the population, but consume 40% of prescription drugs and 35% of all over the counter drugs
  • On average, individuals 65 to 69 years old take nearly 14 prescriptions per year, individuals aged 80 to 84 take an average of 18 prescriptions per year
  • 15% to 25% of drug use in seniors is considered unnecessary or otherwise inappropriate
  • Adverse drug reactions and noncompliance are responsible for 28% of hospitalizations of the elderly
  • 36% of all reported adverse drug reactions involve an elderly individual
  • Each year 32,000 seniors suffer hip fractures caused by medication-related problems

Statistics courtesy the American Society of Consultant Pharmacists

David Lee, PharmD and PhD, Oregon State University/Oregon Health and Science University, College of Pharmacy, Portland, and a study co-author, explained that the research team looked at 14 medical conditions that commonly affect people over the age of 65, such as high cholesterol, arthritis, heart disease and hypertension. Since many health care professionals treat conditions “one at a time” – meaning they prescribe for one health issue without considering that the treatment may conflict with another ongoing one – there is a big opportunity for negative interactions. For example, the standard recommendation for people with high blood pressure or heart disease are beta blockers. “However, if the patient already suffers from COPD, a nonselective beta blocker can cause airways to constrict and make the COPD worse,” said Dr. Lee.COPD, or chronic obstructive pulmonary disease is a progressive disease that makes it hard for a person to breathe.

Even more alarming is the finding that when “therapeutic competition” was discovered, the study found that physicians changed drug treatments in only 16 percent of the cases. The rest of the time, the competing drugs were continued. According to the study, the most common competing chronic conditions included hypertension (also known as high blood pressure) and osteoarthritis; hypertension and diabetes; hypertension and COPD; diabetes and coronary artery disease; and hypertension and depression.

In addition, multiple drug therapies can lead to an increase in falls, delirium, dizziness, fatigue and anorexia.

Protect yourself and your loved ones

“Right now we’re probably treating too many conditions with too many medications. There may be times it’s best to just focus on the most serious health problem, rather than use a drug to treat a different condition that could make the more serious health problem even worse,” said Dr. Lee.

Experts suggest that if you (or someone you love) are being prescribed several drugs for different conditions to follow these guidelines:

  • When you go to a physician, make sure you bring a list of all your medications (including homeopathic and herbal supplements) and dose levels. (Remember to update your list.)
  • Just because a drug is available without a prescription doesn’t mean it can’t interfere with other drugs you are taking or conditions you have. Check with your doctor before taking any.
  • When you are prescribed something new, ask your doctor why, whether it can make another one of your conditions worse and if it can interact negatively with other medications? Is there something else you can take that won’t interact?
  • If there is a possibility of interaction, ask your doctor what side effects to look for. If you experience any, get to a doctor right away. (Sometimes side effects can be just dose related – you are taking too much.)
  • Talk to your pharmacist. “Pharmacists are really skilled at picking up possible drug interactions, disease-disease interactions or drug-disease interactions,” said Dr. Lee.
  • If you don’t feel your present doctor understands this issue, see a geriatrician – they are well-trained at evaluating the total picture of the patient. (You can find one in your area at The American Geriatrics Society.)

For more information about side effects of drugs seniors are typically prescribed, check out these additional stories:


Beth Levine

Beth Levine

Beth Levine is an award-winning writer based in Stamford, CT. www.bethlevine.net


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