About three out of four older Americans have more than one chronic health condition, and more than 20 percent of them are being treated with drugs that work at odds with each other – the medication being used for one condition can make the other condition worse.
Treating conditions “one at a time” even if the treatments might conflict is often used by health care providers, because little information exists to help them consider this problem, weigh alternatives, and identify options.
When drug competition occurred, the study found that drug treatments were changed in only 16 percent of the cases.
“Many physicians are aware of these concerns but there isn’t much information available on what to do about it,” said David Lee, assistant professor, Oregon State University/Oregon Health and Science University College of Pharmacy.
“Drugs tend to focus on one disease at a time, and most physicians treat patients the same way,” Lee said. “As a result, right now we’re probably treating too many conditions with too many medications.”
More research and more awareness of the number of older consumers affected are needed, he said.
It may be possible to make better value judgments about which health issue is of most concern, whether all the conditions should be treated, or whether this “competition” between drug treatments means one concern should go untreated, he said. It may also be possible to find ways to treat both conditions without conflict.
An example is patients who have coronary heart disease and chronic obstructive pulmonary disease or COPD. Beta blockers are often prescribed to treat the heart disease, but those same drugs can cause airway resistance that worsens the COPD.
“There are several types of beta blocker that don’t cause this negative interaction, but many of the other types are still prescribed anyway,” Lee said.
The chronic conditions where competing therapies occur include coronary artery disease, diabetes, COPD, dementia, heart failure, hypertension, high cholesterol, osteoarthritis, and others.
“More than 9 million older adults in the United States are being prescribed medications that may be causing them more harm than benefit,” said Jonathan Lorgunpai, a medical student at the Yale School of Medicine and co-author of the study.
Competition between medications isn’t the only concern, according to the study. Use of multiple medications can also lead to increased falls and delirium, dizziness, fatigue, and anorexia.
The study was done by researchers from OSU and the Yale University School of Medicine and involved 5,815 community-living adults between the years 2007-09.