Report raises concerns about overmedicating seniors.

Here's more reason to pay attention to prescription drug prescribing patterns in your facility: A pharmacy healthcare services provider's analysis of medication alerts issued for senior enrollees found that overmedicating more than doubled from 1999 to 2002. Although Medco Health Solutions' data pertain to its 6.3 million senior enrollees receiving drugs via retail pharmacies or home delivery, the prescribing trends highlighted in its report likely have implications for long-term care, as well.

Medco Health's senior drug utilization review (SDUR) system issued 7.9 million medication alerts in 2002: 2.2 million for prescriptions exceeding the clinically recommended dose for a senior age 65 and older, 2.4 million for drugs that are clinically inappropriate for the elderly and could lead to harm, and more than 3 million for interactions between two or more medications. "Not every alert posted is cause for alarm," said Dr. Robert Epstein, chief medical officer at Medco Health. "However, we frequently find incidents with antianxiety medications and sleep aids that are prescribed at too high a dose for seniors, which can in turn cause confusion and falling. In addition, we often see concurrent use of blood thinners and aspirin-like drugs which can cause bleeding; and we find many patients being prescribed both beta agonists for lung issues and beta blockers for the heart, which may cancel each other out or lead to a worsening of one or both conditions."

In reviewing prescription drug therapies of more than 650,000 senior patients aged 65 or older in conjunction with its 2003 Drug Trend Report, Medco Health found that one in tour of its seniors used a narcotic for more than 30 days and 1 in 10 used more than three narcotics in 2002. Medco Health also found that its average senior client's prescription drug costs are the same as those of a typical family of four, and its average senior receives 25 prescriptions annually, with the leading types being drugs for high blood pressure, antibiotics, cholesterol lowering agents, and non narcotic pain relief drugs.