New plan to cut harm from too much medicine in older people

“Fifty per cent of older Australians are taking too many medicines that are harmful or unnecessary,” says Professor Sarah Hilmer of the University of Sydney, the lead author of recommendations for a strategic action plan to reduce the harms of polypharmacy.

The report, 'Quality Use of Medicines to Optimise Ageing in Older Australians', says use of too many medicines has serious side effects, including falls, confusion, loss of independence, extra hospital admissions and deaths.  These may be misattributed to ageing itself but unlike ageing may be reversible. 

Professor Hilmer says polypharmacy also burdens the health system.

“First, polypharmacy contributes to the over $1 billion national annual cost of medicine related hospital admissions. Second, the over-prescribing of medicines probably adds hundreds of millions of dollars each year to annual medicine expenditure.”

Published by the University of Sydney’s Cognitive Decline Partnership Centre, in collaboration with the Australian Deprescribing Network and NPS MedicineWise, the report makes seven recommendations aimed at halving harmful or unnecessary medicines use by older Australians within five years.

“This can only be widely achieved with a coordinated approach that integrates action by government, doctors, pharmacists and relevant stakeholders,” says Dr Hilmer, a professor of geriatric pharmacology.  ‘We need top down as well as bottom up strategies’. 

The report is timely because the World Health Organisation recently issued its third global patient safety challenge: Medication without harm, which challenges all countries to reduce inappropriate polypharmacy.   

“There is increasing evidence that deprescribing—the supervised withdrawal—of harmful or unnecessary medicines is safe and benefits the individual and the community.” Nine out of ten older people say that they would like to stop one of their medicines if their doctor said they could. 

NPS MedicineWise CEO Steve Morris said with two out of three Australians over 75 taking five or more medicines, and approximately half of all older adults taking a medicine that is harmful or unnecessary, this report is an important step toward improving health in older people.

“Not using medicines wisely has an impact on the individual but also a big impact on the health care system and society as a whole,” said Mr Morris.

“All parts of the health care system need to work together to help improve the balance of benefit versus risk to older people who are taking medicines.

The report was formulated with input from health professionals, academics, government and consumers.

The report is available here.