Several risk factors point to the use of high-risk medications in older veterans
Research Activities, June 2012, No. 382
Certain medications are not appropriate for the elderly and may cause more harm than good. These include certain antihistamines, analgesics, muscle relaxants, psychotropics, and cardiac medications. A list of these medications has been established by the National Committee on Quality Assurance to be used as a benchmark by Medicare and other managed care plans. Although use of these high-risk medications showed a modest decline between 2003 and 2006, some medications rose in usage.
The researchers retrospectively looked at medication use by 1,567,467 veterans 65 years of age and older, who received care from 2003 to 2006 from outpatient clinics run by the Department of Veterans Affairs (VA). The veterans' exposure to these high-risk medications decreased from 13.1 percent in 2004 to 12.3 percent in 2006. Significant reductions were found for opioid pain relievers, muscle relaxants, psychotropics, endocrine medications, cardiac drugs, and vasodilator medications. However, relative increases were discovered for amphetamines (10.3 percent) and ketorolac (8.0 percent), a nonsteroidal anti-inflammatory drug (NSAID). A statistically significant increase in exposure was also found for the antibiotic nitrofurantoin (36.5 percent). Patients more likely to be exposed to these high-risk medications were female, Hispanic, took a higher number of medications, had a coexisting psychiatric problem, and had a high use of primary care. The study was supported in part by the Agency for Healthcare Research and Quality (HS17695).
See "Trends in use of high-risk medications for older veterans: 2004 to 2006," by Mary Jo V. Pugh, Ph.D., Joseph T. Hanlon, Pharm.D., M.S., Chen-Pin Wang, Ph.D., and others in the October 2011 Journal of the American Geriatrics Society 59(10), pp. 1891-1898.