Medication Safety for Seniors: Are We Doing Enough?
"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
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.
- 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.
Recent Research Priorities
The World Health Organization published a systematic review on the global burden of preventable medication-related harm in health care on 7 March 2024. A study published on October 15, 2024, systematically evaluated interventions designed to improve medication safety behaviors among older people with chronic diseases. A January 27, 2025, update identified four exemplary 2023 articles that advanced research on medication-use quality and safety in older adults.
Persistent Medication Problems
Medication use problems remain prevalent among older adults in primary care. The problems identified include nonadherence, adverse drug events, limited accessibility, polypharmacy, inappropriate medications, medication beliefs, inadequate knowledge and awareness, and insufficient deprescribing. A 2023 analysis also examined factors contributing to medication-related problems among older adults in the rapidly aging Association of Southeast Asian Nations, underscoring the need for effective solutions and strategies.
Comparing Medication Choices
The 2023 AGS Beers Criteria research categorized medications according to the clinical conditions for which they are commonly used in older adults. The analysis recognized that some medications listed in the AGS Beers Criteria appear in more than one condition category and examined alternative treatments for selected medications. Comparisons remain difficult because information about medication efficacy and safety in older adults, particularly those who are frail, is often absent.
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.
Systemic Barriers to Safety
Managing multiple prescriptions increases the risk of dangerous drug interactions, according to MedShadow's March 12, 2025, medication safety guide for older adults and caretakers. Medication safety also depends on older adults' ability to advocate for themselves and participate in medication and deprescribing conversations. A March 11, 2025, paper described these conversations as shaped by patient experience, context, and complex, multilevel relationships.
Safety and Quality of Life
The World Health Organization describes how taking a large number of drugs without regular medication reviews can have a devastating effect on quality of life and patient safety, especially for older people. In one real-life story, regular medication review helped Dora resume her usual daily trip to town and return to an independent life. Medication safety can also involve multidisciplinary, patient-centred cooperation, as illustrated by a non-blinded, multicentre stepped-wedge cluster randomised clinical trial conducted in six French University Hospitals.