Too many pills pushing NZ's elderly into care prematurely

A new push is underway to tackle the growing concern of our elderly being forced into care prematurely due to their pills.

Researchers are testing the latest health technology to see which older patients are at risk of overmedication. Source: 1 NEWS

International studies show 15 to 20 per cent of hospitalisations among older patients are caused by either the side effects of their drugs or overmedication.

The risk for drug errors is seven times greater in seniors than in people under 65, with common adverse reactions of oversedation, confusion, hallucination, falls and bleeding.

"As you get older you tend to accumulate more long-term medications and they kind of build-up," says Canterbury DHB geriatrician Dr Nigel Millar.

"Each one has a good reason behind it, but every so often you've got to think is this the right mix of medications?" 

It's often difficult to monitor each drugs' effectiveness and the outcomes of those medicines interacting - Dr Hamish Jamieson, Otago University researcher

Now, as part of the government's Ageing Well National Science Challenge, Otago University has launched a study to test a new electronic monitoring system, to see if it can accurately predict which elderly patients are most at risk.

"Inappropriate drug prescription often causes elderly New Zealanders to die prematurely or suffer falls and early admission to rest homes," says Otago University researcher and geriatrician Dr Hamish Jamieson.

"Elderly are commonly on multiple medications that all have numerous potential side effects and it's often difficult to monitor each drugs' effectiveness and the outcomes of those medicines interacting."

The study is comparing patient outcomes on a world-leading Ministry of Health database of 80,000 elderly patients' health information, with results from a newly-developed electronic measure called the Drug Burden index or DBI.

Elderly couple with walking frames. Source: 1 NEWS

The aim is to test whether the DBI can accurately predict which elderly are most at risk of drug harm.

Researchers say is the DBI does predict adverse events from drug interactions it could allow doctors to electronically calculate the risk before medicines are prescribed, potentially preventing harm and saving lives.

Each patient's individual DBI calculation score would potentially throw up a "red flag" on the patient's electronic medical record. 

"The benefit would be that the patient and clinician could see that and use that together, to see if continuing to use these medications is appropriate," says Dr Jamieson.

If not, the patient could be taken off that drug, have the level of that drug reduced or be prescribed another one.

Researchers hope a pilot project using the DBI, involving GPs and pharmacists, might be underway by the end of this year.