Elderly woman surrounded by glowing prescription bottles, symbolizing medication safety in elderly care.

Medication Safety for Seniors: Are We Doing Enough?

Kai Mendoza in Health & Wellness December 2025 • 4 min read.

"A deep dive into the risks of inappropriate medication use in elderly care facilities and what can be done to promote safer prescribing practices."

As populations worldwide age, ensuring the health and well-being of our senior citizens becomes increasingly vital. One area of particular concern is medication safety, especially for those residing in long-term care facilities. These individuals often face complex health challenges, requiring multiple medications, which can inadvertently lead to adverse drug reactions and reduced quality of life.

A 2012 study published in the Brazilian Journal of Pharmaceutical Sciences sheds light on this critical issue, examining the prevalence of potentially inappropriate medications (PIMs) and potentially hazardous drug interactions (PHDI) among elderly residents in a long-term care facility in São Paulo, Brazil. The study also explores the impact of pharmaceutical interventions aimed at promoting safer therapeutic alternatives.

This article delves into the findings of this research, highlighting the risks associated with PIMs and PHDI in elderly care, and explores potential solutions to improve medication safety and enhance the well-being of our aging population. The goal is to raise awareness and empower individuals to advocate for better pharmaceutical care for themselves or their loved ones.

The Hidden Dangers of Inappropriate Medication Use in Elderly Care

Elderly woman surrounded by glowing prescription bottles, symbolizing medication safety in elderly care.

The study revealed that a significant percentage of elderly residents in the long-term care facility were prescribed potentially inappropriate medications (PIMs). Approximately 88% of the residents took at least one drug, and 30% of them had been prescribed a PIM. This highlights a concerning trend of over-medication and the potential for adverse health outcomes.

What makes a medication "inappropriate" for elderly individuals? According to the Beers criteria, a widely recognized standard, PIMs are drugs that pose a higher risk of side effects and adverse reactions compared to their potential benefits, especially in older adults. These medications may also have safer alternatives available.

Here are some of the most common types of PIMs identified in the study:

Central Nervous System Drugs: Medications like diazepam, amitriptyline, and thioridazine, which can cause sedation, confusion, and increase the risk of falls.
Cardiovascular Drugs: Medications like digoxin and amiodarone, which can lead to heart rhythm problems and other cardiovascular complications.
Antibiotics: Medications like nitrofurantoin, which can cause kidney problems and other adverse effects.

In addition to PIMs, the study also identified potentially hazardous drug interactions (PHDI) among the residents. These interactions occur when two or more medications interfere with each other, increasing the risk of side effects or reducing the effectiveness of one or both drugs. Polypharmacy, the use of multiple medications, was found to be a significant risk factor for both PIMs and PHDI, underscoring the importance of careful medication management in elderly care.

Empowering Safer Medication Practices for a Healthier Aging Population

The study's findings underscore the urgent need for improved medication safety practices in long-term care facilities. While pharmaceutical interventions, such as sending guidance letters to physicians, may have limited impact on their own, a multi-faceted approach is essential to promote safer prescribing practices and reduce the risks associated with PIMs and PHDI. This includes ongoing education and training for healthcare professionals, medication reviews, and the integration of pharmacists into healthcare teams.

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Everything You Need To Know

What are Potentially Inappropriate Medications (PIMs) and why are they a concern for seniors in long-term care?

Potentially Inappropriate Medications (PIMs) are drugs that pose a higher risk of side effects and adverse reactions compared to their potential benefits, especially in older adults. They are a concern because elderly individuals in long-term care facilities often have complex health challenges requiring multiple medications, increasing the likelihood of being prescribed PIMs. This can lead to adverse health outcomes, reduced quality of life, and increased healthcare costs. The Beers criteria are often used to define what constitutes a PIM.

Besides PIMs, what other medication-related risks do elderly residents in long-term care facilities face?

Elderly residents in long-term care facilities also face the risk of Potentially Hazardous Drug Interactions (PHDI). These interactions occur when two or more medications interfere with each other, increasing the risk of side effects or reducing the effectiveness of one or both drugs. Polypharmacy, the use of multiple medications, significantly raises the risk of both PIMs and PHDI, making careful medication management crucial. Understanding how drugs interact in older adults requires a comprehensive review of their medication profiles.

What specific types of medications are commonly identified as Potentially Inappropriate Medications (PIMs) for seniors?

Several types of medications are commonly identified as PIMs. These include: * Central Nervous System Drugs: Such as diazepam, amitriptyline, and thioridazine, which can cause sedation, confusion, and increase the risk of falls. * Cardiovascular Drugs: Such as digoxin and amiodarone, which can lead to heart rhythm problems and other cardiovascular complications. * Antibiotics: Such as nitrofurantoin, which can cause kidney problems and other adverse effects. These medications have safer alternatives available or pose significant risks that outweigh their benefits in older adults.

What approaches can be adopted to enhance medication safety and lower the dangers linked to PIMs and PHDI in elderly care facilities?

A multi-faceted approach is essential. While pharmaceutical interventions like sending guidance letters to physicians may have limited impact alone, combining them with ongoing education and training for healthcare professionals, regular medication reviews, and the integration of pharmacists into healthcare teams can significantly improve medication safety. This comprehensive strategy ensures safer prescribing practices and reduces the risks associated with PIMs and PHDI, leading to better health outcomes for elderly residents.

How does polypharmacy contribute to medication-related risks among the elderly, and what measures can be taken to mitigate these risks?

Polypharmacy, the use of multiple medications, significantly elevates the risk of both Potentially Inappropriate Medications (PIMs) and Potentially Hazardous Drug Interactions (PHDI) in elderly individuals. As the number of medications increases, so does the likelihood of adverse effects, drug interactions, and reduced medication adherence. To mitigate these risks, comprehensive medication reviews are crucial. These reviews should involve healthcare professionals, including pharmacists, who can identify and address potential PIMs and PHDI, optimize medication regimens, and educate patients and caregivers on proper medication management.