Annual prescription check-ups for seniors could curb overprescribing: study

A man prepares to take his daily medication. (Kampus Production/pexels.com)

Annual check-ups for seniors to talk about their medications could curb the trend of overprescribing, according to a new study by researchers at McGill University and the University of Toronto.

The findings note that in Canada, two out of three adults aged 65 or older take five or more medications.

“We have a significant issue with overprescribing in Canada and globally. Patients taking 10, 15 or even 20 medications are not uncommon,” said co-lead author Dr. Emily McDonald, an associate professor with McGill’s Department of Medicine. 

• READ MORE: Online tool helps reduce number of meds prescribed to elderly patients: Montreal study

The study points out that while often necessary, “complex drug regimens can increase the risk of side effects and affect quality of life.”

“Complex drug combinations are rarely studied together and can interact in unpredictable ways, contributing to falls, confusion, bleeding complications and other effects that are often mistaken for normal aging,” the researchers stated.

As there has been little guidance for clinicians, medication reviews often happen only after a complication arises, McDonald added. 

The researchers, having examined more than 100 clinical trials, are now recommending annual medication reviews for adults 65 or older, particularly for those taking five or more medications.

The goal is to avoid unnecessary or potentially harmful prescriptions and, where appropriate, reduce or stop them.

• READ MORE: Study finds too many Quebec seniors being overprescribed inappropriate medications

“Patients should understand their medications and feel empowered to ask whether non-drug options are possible,” said McDonald, who directs the Canadian Medication Appropriateness and Deprescribing Network.

The authors also highlight the need for government support to make checkups more widely available through physicians, pharmacists and nurse practitioners.

The stats

According to Canada’s Drug Agency, the number of medications prescribed to people increases with age: seven per cent of people aged 18 to 39 take three or more medications, 22 per cent of people aged 40 to 59 take three or more medications, and 62 per cent of those aged 65 and older take five or more medications.

“Sometimes, multiple medications are the right choice for a person’s care,” the agency notes. “However, the more medications a person takes, the higher the risk of side effects. Individuals who take five or more medications are more likely to experience harms and to be prescribed a potentially inappropriate medication.”

• READ MORE: Quebec doctors warn against ADHD medications being overprescribed

Some of the harms associated with potentially inappropriate medication use include:

• Side effects (dry mouth, confusion, diarrhea);
• Falls and fractures;
• Interactions with other medications;
• Hospitalizations;
• Increased drug costs: At least $1 billion annually is spent on potentially inappropriate medications.

The agency estimates that 44 per cent of people 65 and older take at least one potentially inappropriate medication, such as sleeping pills, antipsychotics or proton pump inhibitors.

It adds that women are more likely to be prescribed an unnecessary medication.

The study, Screening for potentially inappropriate prescribing in primary care, was published in Canadian Family Physician.