Medication‐related problems commonly occurring in an Australian community setting

Abstract

This analysis reveals the need for ongoing vigilance of, and support for, people at high risk of medication misadventure. This information is also useful for informing the design of public health or health promotion strategies aiming to reduce the prevalence of these problems.

Inappropriate prescribing in hospitalized elderly patients

“…An Australian study conducted by Roughead et al among 1000 patients living in the community illustrated that one in three people were found to require additional monitoring. 29 Cardiovascular drugs, especially digoxin and diuretics, were the most common medications requiring additional monitoring. Monitoring drug use involves: documenting the indication for a new drug, keeping a current list of drugs used by the patient in medical records, monitoring for achievement of therapeutic goals and other responses to new drugs, monitoring necessary laboratory tests for efficacy or adverse effects, and finally periodically reviewing drugs for continued need.…”

“…2 Failure to adjust doses in elderly people is common. 13,29 A general approach when prescribing drugs to elderly people would be to start with a small initial dose and titrate this dose to a clearly defined therapeutic response. 30 Conventional wisdom supports the use of lower doses when prescribing drug treatment for elderly patients.…”

Concomitant prescription of psychotropic and cardiovascular drugs in elderly patients

“…Several epidemiological studies indicate that the most common prescription drugs among persons aged 70 years or over are also cardiovascular drugs followed by psychotropic drugs [3,4]. Depression and psychotropic medication increase the risk of cardiovascular disorders [5,6].…”

Prescriber Feedback to Improve Quality Use of Medicines among Older People: the Veterans' MATES Program

“…1 In those who use multiple medications, medication-related problems are also common. 2,3 Australian studies suggest that people at high risk of medication misadventure have on average three to four medication-related problems. 4,5 These medication-related problems also result in patient harm, with up to one-third of unplanned hospital admissions in older people being medication-related, of which 32% to 77% may be preventable.…”