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article imageOne in five seniors take medications that work against each other

By Karen Graham     Mar 14, 2014 in Health
Over 75 percent of older Americans have multiple health problems, and more than 20 percent of them are being treated with medications that actually work against each other. This therapeutic competition is putting many seniors at risk.
It is common practice in medicine today to treat conditions "one at a time," even if the treatment regime might conflict with another treatment being used. This is happening because there is little information available to aid a medical practitioner in considering a problem, weighing alternatives and identifying different options.
The potential problems arising from therapeutic competition, using medications to treat one condition, while not realizing the treatment could possibly counteract, or even exacerbate another condition, was the premise for a study to determine the prevalence of potential therapeutic competition in community-living older adults.
Researchers from Oregon State University (OSU) and the Yale University School of Medicine, conducted a study of older community-living adults from 2007-2009. The lead author of the study, supported by the National Institutes of Health, was Dr. Mary E. Tinetti at Yale University. The study included 5,815 community-living adults, a nationally representative sampling of older adults, both men and women.
In order to do the research, using Medicare claims, the team was able to identify the 14 most common conditions where medications being used for one condition may exacerbate the other. They included hypertension and osteoarthritis; hypertension and diabetes; hypertension and COPD; diabetes and coronary artery disease; and hypertension and depression.
As an example of medications that could compete with each other, to the detriment of the patient, some older adults with both coronary heart disease and chronic obstructive pulmonary disease (COPD), are sometimes prescribed Beta Blockers, but these same medications can exacerbate the symptoms of COPD, causing airway resistance.
The study found that over 20 percent of older adults took at least one medication that could adversely affect another of their chronic conditions. The study estimates reflect the prevalence of potential therapeutic competition in the older U.S. population as a whole. It was determined that the reason for the high frequency of competing medications was due to the multiple chronic conditions seen in older adults and the benefits of the medications being used.
"More than 9 million older adults in the U.S. are being prescribed medications that may be causing them more harm than benefit," said Jonathan Lorgunpai, a medical student at the Yale School of Medicine and co-author of the study. "Not only is this potentially harmful for individual patients, it is also very wasteful for our health care system."
While direct competition between some medications is potentially harmful, the use of multiple medications can also lead to increased numbers of falls and delirium, dizziness, fatigue and anorexia. With statistics showing that one in three older Americans will suffer a fall this year, this is all the more reason for care-givers or family members to ask the primary care physician to re-examine all medicines being prescribed, looking for therapeutic competition.
More about Older people, Medications , therapeutic competition, working against each other, Physicians
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