Seniors More Prone to Medication Risks

Apr 16, 2015
Someone older than 65 takes an average of six medications a day, adding up to 258 million prescriptions.
  • Medicare
  • Pain
  • Seniors

Americans are living longer, thanks in part to medical and pharmaceutical advances that help us stay healthier and combat once deadly diseases. But, ironically, those same medications could do harm if not properly monitored and managed.

The average life span of a child born in 2013 was 80 years old, more than a decade longer than their grandparents who were born in 1950. And the Baby Boomers are reaching retirement age in droves.

That means there are more of us who are older – 43 million Americans age 65 and up were counted by the Census Bureau in 2012, and that number will nearly double to 84 million people by 2050.

That added longevity is good news, but it also means that more people are taking more drugs. Someone older than 65 takes an average of six medications a day, adding up to 258 million prescriptions in 2012.

Complicating Factors

Some of the potential complications are well known: A more complex medication regimen – involving, for example, some drugs that need to be taken in the morning with food, and others that can only be taken on an empty stomach at night – requires greater care to avoid harmful side-effects. When seniors see several doctors, and receive their medications from more than one pharmacy, the chances of a dangerous interaction will increase.

But what many people don’t realize is that the very process of aging makes older adults more prone to medication-related risks.

As people age, their body composition tends to shift toward less water and more fat tissue – and solubility is a core factor in how drugs work. Medications that dissolve in water become more concentrated in a body that contains less of it. And people with a greater amount of fat tissue will accumulate more of a drug that dissolves in fat.

In addition, older people’s kidneys are less able to excrete drugs than when they were younger, and their liver is less able to break down and metabolize them. So a medication may linger longer in the body.

As a result, physicians may have to decrease the dose or adjust the timing of an aging patient’s prescription to avoid unwanted side effects and complications. Pharmacists who have a comprehensive view of all the medications a patient is taking, and who are on guard for these types of issues, can help ensure that only the right medications, at the right dose and at the right time, are dispensed.

Opioids: An Increasing Risk

One area that may require particular vigilance is seniors’ use of narcotic prescription pain medications known as opioids – drugs such as codeine, morphine, OxyContin® and Vicodin®.

According to Express Scripts research, older Americans who were taking only opioids for pain treatment had a significant increase in prevalence of use, up 4.5% from 2009 to 2013. This was largely due to changing clinical standards that shifted seniors to opioids from NSAIDs (nonsteroidal anti-inflammatory drugs), which were found to cause harmful side effects in the elderly.

Increasing and potentially dangerous opioid use is part of a nationwide trend across age groups. But there are particular risks to older adults. Because of their sedating properties, opioids can lead to a greater risk of falls among seniors, who are twice as likely as patients on non-opioid pain medications to experience a hip fracture. Additionally, the number of medications seniors tend to take at once makes it more likely that they may suffer from a dangerous drug interaction.

Mitigating Risks and Improving Pharmacy Care for Seniors

It is important that older adults be prescribed the lowest dose possible to treat their pain – and Express Scripts’ specialist pharmacists can play an important role in ensuring that is the case.

Author Bio

Lab Staff
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