The number of older Americans over the age of 65 not living in healthcare facilities who used prescription medications rose from 1999 through the mid-2000s and hasn’t changed much since. The percentage of older adults using multiple prescription medications — known as polypharmacy — increased by 4% since 2011-2012. During that time span, use of eight of the most popular medications increased as well as chronic conditions and adverse drug events, according to data published Monday in JAMA Internal Medicine.
Data came from the National Health and Nutrition Examination Surveys (NHANES), which included people over 65 who weren’t living in healthcare facilities or other institutions. It included different survey periods.
The analysis didn’t include over-the-counter medications. The authors admitted the data didn’t represent older adults living in healthcare facilities including nursing homes. Polypharmacy was using five or more medications, while hyperpolypharmacy was using more than 10.
Between January 1999 and March 2020, researchers tracked medication use in 14,917 participants aged 65 years or older. From 1999-2000 through 2005-2006, use of any medication increased from 83.9% to 90%. The average number of medications people were on went from 3 to 3.9 from 1999-2000 to 2017-2020.
Among the top 10 most-used level 1 medications, use of five of them went up over the span of the study: cardiovascular, coagulation, gastrointestinal, metabolic and psychotherapeutic agents. Among level 2 medications (that includes antidepressants, ACE inhibitors and antihyperlipidemic agents to name a few), six of the top 10 were cardiovascular agents and use of three of them rose.
Polypharmacy increased from 23.6% in 1999-2000 to 35.9% in 2003-2004 and rose to 43% in 2017-2020. Hyperpolypharmacy increased from 1.8% in 1999-2000 to 6.1% in 2007-2008. Potentially inappropriate medication use declined from 48.8% to 44.6% during the entire study period, which spanned 1999 to March of 2020.
“Medications are crucial for managing illnesses and saving lives but contain risks. Understanding medication patterns can inform prescribing practices to reduce adverse drug events risk and unnecessary polypharmacy, hyperpolypharmacy and potentially inappropriate medications,” the authors wrote.
