The use of drugs among the elderly: the role of pharmacists
THEORY
< 12%
< 14%
< 16%
17%
Source: European Health For All Database, WHO/Europe, various years (1997-2004)
Proportion of citizens aged ≥ 65 years in Europe
Use of drugs in Italy by age and sex
2007 (Report OsMed 2007 – Agenzia Italiana del Farmaco)
A patient of 75 years or older takes 17 times more drugs compared to a young adult of 25-34 years.
The paradox of drugs:
"Medication is probably the single most important healthcare technology in preventing injury, disability and death in the geriatric population."
(Avorn J. Medication use and the elderly: current status & opportunities. Health Aff, 1995)
"Any symptom in an elderly patient should be considered a drug side effect until proved otherwise."
(Gurwitz et al. Long-term Care Quality Letter - Brown University, 1995)
BENEFIT
RISK
Limits to pharmaceutical therapies for the elderly…
Scientific
evidence
Inappropriate
drugs
Polytherapy
pharmaceutical interactions
adherence to treatment
Adverse reactions
Physiological alterations
Problems related to drug therapy for elderly people
Elderly people have a risk of developing adverse effects almost double that of younger people (Br J Clin Pharmacol, 2002)
30% of hospital admissions among elderly people are caused by adverse effects of drugs, which is considered the fifth leading cause of death in hospitals (J Am Geriatr Soc, 2001)
20% of older people in Europe receive at least one inappropriate drug (JAMA, 2005)
It has been estimated that in 1994, in the USA alone over 100,000 people died due to an adverse reaction to a drug (JAMA, 1998)
Which drugs
(Pirmohamed M et al. Adverse drug reaction as cause of admission to hospital. BMJ, 2004)
Admissions
ADRs/tot
1,225/18,820=6.5%
(16% pharmaceutical interactions)

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