Patients given unsuitable medicines, study finds

Some 52 per cent of elderly patients admitted to a Cork hospital over a four-month period last year were found to be on one or…

Some 52 per cent of elderly patients admitted to a Cork hospital over a four-month period last year were found to be on one or more inappropriate or potentially inappropriate medications, according to a new study.

The research, conducted on about 600 patients, found that in some instances the patients had been admitted to Cork University Hospital as a direct result of their inappropriate medication.

However, Dr Denis O'Mahony, a consultant geriatrician involved in the research, said yesterday that the inappropriate medications would have been responsible for admissions in "a minority" of cases only.

He said that apart from the potentially harmful effect inappropriate medication could have on patients, the cost of the drugs inappropriately prescribed was also substantial. The cost of the inappropriate medication given to the cohort of patients in this study amounted to €10,000 in one month.

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Dr O'Mahony said there would also be additional costs associated with hospitalisation, dispensing fees and disability. "Very occasionally a wrong or inappropriate prescription can lead to death," he said.

He stressed the findings didn't mean that more than half of all over 65s were on inappropriate or potentially inappropriate drugs. The finding related to a group of older, sicker, more frail people admitted to hospital, he said.

The medications would have been prescribed mainly by GPs but Dr O'Mahony said prescribing for frail, older people who could have many concurrent illnesses and be on several drugs at the same time was "quite a tricky skill". Over decades "there has been a very serious lack of structured education on prescribing for the elderly in medical schools". There needed to be better quality education for pharmacists also, he said.

The study also found that 57 per cent of the older people surveyed were not on at least one medication that was indicated for their illness and that would be potentially beneficial for them.

The evaluation of whether or not patients were getting all the appropriate medications or in fact getting inappropriate medication was carried out using two tools devised by a panel of up to 20 experts, including expertise from the UK. The panel included consultants in geriatric medicine, clinical pharmacology, senior academics in general practice and senior academics in pharmacy.

Dr Eamonn Shanahan, chairman of the Irish College of General Practitioners, said he was a little surprised the figure was so high for inappropriate prescribing by GPs. "We should take note of it and act accordingly," he said.

Age Action Ireland said the study was "a major cause of concern".