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  • Elderly inpatients on more than 10 drugs

    Author: AAP

Hospital wards are an ideal setting to discontinue inappropriate medications for older people, say researchers.

Australian hospitals are missing the chance to safely reduce the number of medications being prescribed to elderly patients, some of whom are on more than 10 drugs.

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A new study of 1216 patients, aged 70 or older, found three-quarters were receiving five or more drugs on admission, while one-fifth were on 10 or more drugs.

The study, published in the Medical Journal of Australia on Monday, found that on discharge there was very little difference in the number of drugs prescribed.

"This may suggest that active attempts were not made to deprescribe when appropriate," said lead author Associate Professor Ruth Hubbard.

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Prof Hubbard told AAP there was evidence that being on many medications may have adverse outcomes among older people, including side effects or even a reaction requiring hospitalisation.

She stressed that if a person was, say, 85, very robust and fit and living independently in the community, they should have the benefit of drugs that will prevent other diseases.
But prescribing 10 or more medications to a dependent, frail, elderly person with medical issues and possible cognitive problems may not be what they want for the last years of their life.

"Perhaps only a medication review underpinned by careful consideration of the health status of the patient concerned, including estimation of life expectancy and exploration of individual goals of care, is likely to result in clinically meaningful outcomes," the authors said.

"The acute care hospital ward under the care of physicians is a setting in which these complex decisions could be considered and actions initiated in discontinuing inappropriate medications."

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