FRIDAY, June 7, 2002 (HealthDayNews) -- The more medications the elderly ingest, the less knowledge they have about what they're taking. And that lack of awareness can have potentially disastrous consequences.
Only 15 percent of elderly patients interviewed in an urban hospital could correctly list all their medications, dosages, frequencies and side effects, according to a report in the June issue of Annals of Emergency Medicine. And those who took more than three medications a day were the least likely to know what each drug was for.
"Our study reflects poor communication between health-care providers and elderly patients, the complexity of modern medical regimens and the passive role the elderly are taking in their health care," says Dr. Joel Bartfield, co-author of the study and an emergency medicine professor at Albany Medical College in New York.
One of Bartfield's primary concerns: Emergency room personnel could unknowingly give an elderly patient a drug that reacts badly with prescription medicines he might be taking.
Between January and March 2001, Bartfield and Dr. Michael Chung, the study's lead author who was then a senior resident at Albany Medical Center, questioned patients over 65 who came into the center's emergency room. The doctors excluded those who were disoriented, severely ill or unable to identify their pharmacies, but allowed the rest the option to participate.
Of the 77 patients they interviewed, each was taking an average of just less than six prescribed medications. Collectively, they recalled 359 drugs. But when the researchers phoned the patients' pharmacies, they learned that 458 prescriptions had been filled. Only 32.5 percent of the group knew their dosages.
Despite the make-up of the study sample, Bartfield believes age wasn't the pivotal factor. He believes a younger population group taking multiple medications would also experience information overload.
Still, it's senior citizens who usually confront this conundrum. The older people get, the more daily drug cocktails become a fact of life, even for the healthy. Physicians frequently prescribe medications for preventative reasons -- to ward off osteoporosis, control cholesterol counts or lower blood pressure levels, for example.
Because it's a challenge for any patient to keep track of such complex regimens, doctors and pharmacists should preempt the inevitable confusion, Bartfield advises.
"I think that all health-care professionals who deal with patients have a responsibility to educate them about the pills they're taking," he says. "When they come into an emergency room, we need good information about what they are already on. And then it's our job to make sure that additional medications that might be indicated aren't going to interact in an adverse way with what they are already taking."
Each year, approximately 100,000 Americans die from adverse reactions to drugs, according to a 1998 report in the Journal of the American Medical Association.
Without greater understanding and knowledge of the risks related to mixing medications, the numbers are likely to climb, says Bartfield.
"Considering a large number of elderly people go to the emergency departments with adverse drug reactions, and they are the fastest-growing age group, this could become a major public health problem," he adds.
Dr. Jerry Gurwitz, a geriatrician and professor of medicine at the University of Massachusetts, believes the problem is probably greater than the study suggests.
"They excluded a lot of patients from their sample, and you can only expect the situation to be even more problematic with patients who are gravely ill or have memory problems," he says.
Gurwitz, whose primary area of research is in improving drug safety for the elderly, says people should carry written records of their medications and dosages with them. These should include explanations of each drug's purpose.
"Doctors need to help their patients update their lists on every visit and request that they always bring in their medication, whether they're going to their physician's office or to an emergency department," Gurwitz says.
Bartfield agrees that a more standardized approach to patients' medication would help health-care professionals -- pharmacists, private practitioners and emergency-room physicians -- prescribe the appropriate treatment.
But he also recommends that people play a more active role in own their health care.
Older Americans still harbor a "doctor knows best" attitude, he says. Many ask few questions and take little responsibility for their medical treatment.
Better educated consumers, he says, will translate into fewer adverse drug reactions.
What To Do
For more on how mixing medicines can be dangerous, click here. Or read this USA Today story on how more seniors are becoming addicted to prescription drugs.
