The cost to your health – and to the economy – of overprescribing

Too many older Australians are taking multiple medications, study finds.

Are your medications killing you?

Around one million Australians over the age of 70 may be taking too many medications every day.

And for many, that can result in falls, confusion, hospitalisation and even death.

That’s the warning from the University of South Australia, which is aiming to reduce the number of inappropriate medications prescribed for older Australians.

This worldwide problem, known as ‘polypharmacy’, has been described by the World Health Organisation (WHO) as one of the major challenges facing society.

It’s a problem well known to many YourLifeChoices members. One member told us: “Until about 18 months ago, I was taking eight prescribed medications plus five supplements on the advice of doctors, plus periodically being prescribed heavy duty painkillers in addition to the regular painkillers that I had to take every day.

“In spite of continual requests to review all the medications, every doctor I asked simply looked at the list and said they all looked okay and to keep taking them.

“Eventually I became very ill and at that point conducted my own personal revolution. I threw out all the medications and waited to see what would happen.”

This member reported a very positive outcome but that approach is not something YourLifeChoices would recommend.

The member added: “I think we may have become conditioned to just accept whatever we are told by professionals who may, or may not, have our overall health situation clearly in front of them when prescribing.”

University of South Australia researcher Dr Emily Reeve says despite widespread evidence showing the harm that inappropriate medications are causing to older Australians, current guidelines provide few, if any, recommendations for clinicians about when, or how, to stop medications.

“A typical older Australian has four chronic health conditions and is taking six regular medications, one of which is inappropriate, with the potential harm outweighing any benefits,” she says.

“Withdrawing inappropriate medication may seem straightforward, but it’s not. It’s complex, due to a lack of evidence-based guidelines based on robust and internationally recognised methodology.”

A joint University of Western Australia and University of NSW study found that the number of older people taking five or more medicines had increased by 52 per cent between 2006 and 2017, despite evidence that this puts patients at risk of harm and is associated with poor clinical outcomes.

Dr Reeve says that in addition to the health risks, polypharmacy is a huge financial burden for global health systems. In Australia, hundreds of millions of dollars are wasted annually through the prescribing of inappropriate medications, she says. Worldwide, the WHO estimates that $18 billion could be saved by correctly managing medication use.

“The economic benefits of de-prescribing means that governments can direct those savings towards other quality use of medicines and non-drug treatments,” Dr Reeve says.

“The feedback from clinicians is that the lack of guidelines not only limits de-prescription, but it also influences the culture of medicine, suggesting that withdrawing medicines is not as important as prescribing them in the first place.”

Using a $1.5 million federal government grant, Dr Reeve intends to spend the next five years establishing guidelines, testing their implementation in aged care facilities and measuring their effectiveness.

“In residential aged care homes in Australia, inappropriate medications account for around 20 per cent of prescription costs,” Dr Reeve says. “We have an opportunity here to address that issue and redirect that money on high value care instead.”

Another member told YourLifeChoices how her mother’s medications increased after she had had a fall.

“She had her own medication by her own doctor. More medication was added in hospital. She went to a nursing home for respite care and, needless to say, more medication was added.

“When she went home, she had 20 types of medication. This situation must be better managed.”

In YourLifeChoices’ 2019 Retirement Matters survey, 79 per cent of the almost 4500 respondents said they took ongoing prescription medications. The most common were for blood pressure problems, followed by arthritis and heart disease.

Are you taking regular medications? Has the number grown as you have aged?

If you enjoy our content, don’t keep it to yourself. Share our free eNews with your friends and encourage them to sign up.

RELATED ARTICLES

    Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.





    COMMENTS

    To make a comment, please register or login
    Paddington
    8th Jun 2020
    3:46pm
    I have refused to take medication for osteoporosis after much research and reading. I take vitamin K2, monitor my vitamin D levels and calcium levels. My research showed that the drugs for osteoporosis were counterproductive and some you could not come off without rebound fractures. Doctors are not giving me any flack for this decision because they have obviously done their own research.
    On the other hand, you cannot go cold turkey on many drugs. For example, blood pressure meds would send your BP high above your earlier levels before medication. Do any of this kind of thing gradually and under medical supervision.
    Always do your own research and if you are not good at that or have not learnt that in post grad studies then ask someone to help you do that who has relevant qualifications.
    Maggie
    8th Jun 2020
    9:16pm
    I like your advice up to a point.
    Even if you are aware of which sites/writers are reliable, there are so many illnesses with similar symptoms that it's difficult to be sure. I think it's better to stick to doctor's advice.
    And I don't think there is any medicine without side effects.
    Jennie
    8th Jun 2020
    10:37pm
    Comment removed: PLEASE SEEK ADVICE FROM QUALIFIED MEDICAL PROFESSIONALS BEFORE CHANGING OR TAKING ANY MEDICATIONS OR SUPPLEMENTS!
    Sceptic
    9th Jun 2020
    11:56am
    It is so good to get all of this medical advice from non-qualified people - I don't think.
    LeonYLC
    12th Jun 2020
    1:30pm
    PLEASE SEEK ADVICE FROM QUALIFIED MEDICAL PROFESSIONALS BEFORE CHANGING OR TAKING ANY MEDICATIONS OR SUPPLEMENTS!
    Nana Gee
    8th Jun 2020
    4:49pm
    Some pharmacists will do a detailed review of your medication, by appointment, for little or no cost. It is my experience that they sometimes have a deeper knowledge than a GP, which is reasonable given it is their speciality.
    Mez
    12th Jun 2020
    1:02pm
    I TOTALLY AGREE!
    Robyn
    8th Jun 2020
    5:55pm
    It is irresponsible to advise people to drop any of their prescribed medications. As we age and more health problems occur, of course the medications will increase. If you ask your GP or specialist the reason for the medication and what, if any side effects it may cause, then go ahead and take what's prescribed.
    sandyfaye
    8th Jun 2020
    6:59pm
    I'm 75 and take minimum prescription drugs but my younger friend takes so many that she is now over the threshold. She gets hers for free. I'm sure she could dump half of them. Unfortunately she seems proud of how many drugs she takes. Almost skites about it.
    Jennie
    8th Jun 2020
    10:41pm
    My old boss took so many different drugs that they interacted and she developed a psychosis. Fortunately a consultant physician was able to get her off most of them and sort out the problem. Yes my old boss would tell me how (show off...) when she went into hospital she took a carrier bag full of medications. Fortunately after a spell in a psychiatric ward she took the advice given by a wise consultant.
    Mez
    12th Jun 2020
    1:12pm
    Yes, so many do become self absorbed with their illnesses out of loneliness or otherwise.
    Not good, in fact dangerous to give specific medical advice to others!
    One needs to be qualified and also to do so on a one to one basis.
    Everyone reacts differently and certain drugs cannot be given if one is already on certain others, and so on.
    What works for you may not for another!
    sandyfaye
    9th Jun 2020
    10:22am
    Jenny. Why do doctors prescribe stations if they are so dangerous? Are you saying they are paid to do so?
    Sceptic
    9th Jun 2020
    11:59am
    Jenny, they are statins, and they reduce cholesterol.
    Mez
    12th Jun 2020
    12:53pm
    As a nurse, I have seen many cases of poly pharmacy, especially with many elderly in aged care facilities!
    Not only does it involve much of the nurse's time in administration of them but also half of them are likely to be unnecessary because they are prescribed to counter act adverse side effects!
    I personally believe in prevention of ill health by eating healthy and being physically and mentally active as much as one is able to as well as explaining to your GP that that is what you prefer without jeopardising your pre existing medical condition.
    Also, many younger doctors are interested in natural services like naturopathy, osteopathy, physiotherapy and so on.
    In my case, I acquired arthritis of the neck and the accompanying pain at night and movement during the day such as when driving, was relieved with regular use of fish oil capsules which I began using rather sceptically so no placebo effects in this case!
    There are many medical conditions that may be prevented via a healthy lifestyle but sadly, many do not until too late believing that they come only because of old age!
    Our hospital beds are mainly occupied by these types of people!
    Also, note that those people who live well into their 80's and 90's have done so without many medical problems!
    I recall one woman nearly 100 who had only needed to take Panadols all her life and died peacefully in her sleep and another man nearly 90 who was playing competition tennis until his 80's when he had his first stay in hospital in his early 90's! The list goes on and on!
    Mez
    12th Jun 2020
    12:59pm
    Yes, there are medications still being used here in Australia which have been removed overseas and yes, the pharmaceutical companies are there to push the sales to the doctors.
    Adverse side effects occur with many medications as well as depending on individual differences so it is best to have a long consultation booked to discuss all these to determine the best course of action.


    Join YOURLifeChoices, it’s free

    • Receive our daily enewsletter
    • Enter competitions
    • Comment on articles