Up to 31 per cent of elderly patients receive the wrong medication after being transferred into a care centre and three-quarters of nursing home residents receive at least one inappropriate drug, yet the proportion of mistakes causing the death of such frail people is unusually low.
A review led by Joseph Ibrahim of the Department of Forensic Medicine at Monash University examined various studies to determine the global prevalence of medication errors resulting in hospitalisation and death of nursing home residents. In the Journal of the American Geriatrics Society, published yesterday, researchers reported on a high rate of medication errors among older people causing preventable harm and significant financial burden.
However, Professor Ibrahim said the finding that medication errors were fatal in 9 per cent to 15 per cent of occasions involving people aged between 70 and 90 raised the possibility of under-reporting, and of deaths wrongly assumed to be due to underlying illnesses.
“We were expecting much larger numbers because older people have as many as three to five other diseases, tend to be over 80 and don’t have much reserve,” he said. “I think society in general undervalues older people, particularly older people who are in nursing homes, assumed to be waiting to die, for whom (it is assumed) an early death is a good thing.”
Professor Ibrahim said wrong medications, or those given to the wrong person were more often detected than wrong doses or an inappropriate mix of drugs.
He applauded efforts to better manage medication use in older people and the “de-prescribe” movement addressing harmful and unnecessary drug use, but said more research was needed to better target such initiatives.