In some traditional cultures, the elderly are revered. In others, they’re taken out to the woods and left to die. Generally, in America, they’re over medicated, often with harmful or useless drugs.
A recent study of the records of 470,000 patients over 65 who were admitted to an emergency department (ED) between 2000 and 2006 revealed that nearly 17% were given what the medical industry refers to as “potentially inappropriate medications (PIMs)” — in other words, the wrong drug.
“Approximately 19.5 million patients … of eligible ED visits were associated with one or more PIMs,” researchers concluded in their report, published in the March 2010 issue of Academic Emergency Medicine journal (2010; 17:231).
“There are certain medications that probably are not good to give to older adults because the potential benefits are outweighed by potential problems,” admitted lead author, William J. Meurer, MD.
The two worst offenders, which accounted for nearly 40% of the errors, were the drugs promethazine and ketorolac. Promethazine is a powerful and potentially risky sedative which can cause everything from confusion in older patients to, in rare cases, seizures. Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) used as an analgesic, fever reducer, and anti-inflammatory.
This isn’t the first time such results have been shown. In July 1994, the Journal of the American Medical Association reported on a study that revealed close to 25% of all elderly patients received wrong drugs.
Among their findings:
** 1.8 million older people had prescriptions for dipyridamole, a blood thinner that, the researchers say, is useless for all except people with artificial heart valves.
** More than 1.3 million older Americans were given prescriptions for propoxyphene, an addictive narcotic that is no better than aspirin in relieving pain.
** More than 1.2 million were prescribed diazepam or chlordiazepoxide, long-acting sedatives and sleeping pills that can make patients groggy, dizzy, and prone to falls.
“Standard published sources support the view that the 20 drugs in our primary analysis should virtually never be prescribed for the elderly,” researchers stated at the time.
One doctor, Jerry H. Gurwitz, MD, of Brigham and Women’s Hospital in Boston, was quoted in The New York Times as saying he hoped the study would serve as “a wake-up call” to America’s doctors. “I hope that the medical community will take it as seriously as the general public, I think, will,” he said, adding that the study might have actually understated the problem since it did not factor in drug interactions or the long-term effect of drugs like sleeping pills.
If we aren’t going to revere our elderly, it might be kinder to leave them in the woods!