A pharmacist friend recently told me that they had a discussion with their doctor who wanted to prescribe certain medications. His doctor said, “It’s normal for your age.” The pharmacist in question objected to taking these medications.
This kind of comment is frequent and very worrisome when we know that a new study has just highlighted the inappropriate use of certain drugs in the elderly. The National Institute of Public Health of Quebec first published in August 2019: Use of potentially inappropriate drugs in Quebec seniors with chronic diseases or their warning signs: portrait 2014-2015 (French Only). The first conclusion of this report, which has just been published, is as follows: “In 2014, almost half (49%) of Quebec seniors with chronic diseases or their warning signs received at least one potentially inappropriate medication.”
The details of this study have just been published in the scientific journal Family Practice.
This is not a new situation since the first category of medications covered by this evaluation is the use of sleeping pills. A 2018 study by La Presse came to the same conclusion: “More than half of seniors take potentially inappropriate medications, according to a new study from the Canadian Institute for Health Information (CIHI). The issue with use of sleeping pills is particularly blatant in Quebec. This article referred to a Canadian study published by the Canadian Institute for Health Information.
Never stop medication without speaking to your pharmacist or doctor
Be careful, you should never make the decision to stop a medication without talking to your pharmacist or doctor. This could have serious consequences. Not all drugs and uses are inappropriate. The last article mentioned also noted the use of antidepressants and antipsychotics, specifically in CHSLDs.
Medications to avoid or to use with caution as you age are classified each year by what are known as the “Beers criteria.” The American Geriatrics Society (AGS) publishes an update to its Beers criteria each year, which includes lists of potentially inappropriate medications for the elderly. A summary in English of these criteria can be found on the Health in aging Foundation website.
We are here to help you
Speak to your pharmacist or doctor to find out if you are taking any medications that may be inappropriate for you. Sometimes it’s just a long-term medication that has not been re-evaluated for use. The targeted medications are usually utilized as sleeping pills, anxiolytics, muscle relaxants, anticholinergics, decongestants used for sleeping and certain products that counter pain.
Remember that medication is not without risk. You should always be aware of the reason for taking a medication and the risks involved. In closing, here are the 5 questions to ask your pharmacist or doctor according to Dr. Cara Tannenbaum, MD Faculties of Medicine and Pharmacy, Michel-Saucier Pharmaceutical Chair in Health and Aging, Scientific Director, Institute of Women’s and men, Canadian Institutes of Health Research, University of Montreal:
5 questions to ask your doctor or pharmacist:
- Why should I take this medicine?
- What are its benefits at my age?
- What are its risks?
- Can I decrease the dose?
- How to follow up?
You can also refer to the three other articles, written by a pharmacist colleague and a doctor, on aging and the use of medications:
- Aging and the use of medication
- Aging and the use of medication – Article 2
- Aging and the use of medication – Article 3
- Health in aging Fondation, 2019. Ten Medications Older Adults Should Avoid or Use with Caution. THE AMERICAN GERIATRICS SOCIETY. healthinaging.org
- Institut canadien d’information sur la santé, 2018. Utilisation des médicaments chez les personnes âgées au Canada, 2016. 82 pages. ISBN 978-1-77109-706-2 (PDF)
- INSPQ, 2019. Utilisation des médicaments potentiellement inappropriés chez les aînés québécois présentant des maladies chroniques ou leurs signes précurseurs : portrait 2014-2015. Bureau d’information et d’études en santé des populations. Numéro 28.
- Martin et al, 2018. Effect of a pharmacist-led educational intervention on inappropriate medication prescriptions in older adults: The D-PRESCRIBE randomized clinical trial. JAMA. 2018;320(18):1889-1898.