Inappropriate medication use and medication errors in the elderly

Abstract

Medications are commonly used by older adults. While medications can relieve symptoms and prevent further disease complications, they unfortunately can also cause adverse drug events (ADEs). An ADE can be defined as an injury resulting from the use of a drug (Aspden et al. 2007; Nebeker et al. 2004). The right side of Fig. 1 shows the three types of ADEs: (1) adverse drug reactions (ADRs) (i.e., a response to a drug that is noxious and unintended and occurs at doses normally used for the prophylaxis, diagnosis, or therapy of disease or for modification of physiological function); (2) therapeutic failures (TFs) (i.e., failure to accomplish the goals of treatment resulting from inadequate drug therapy and not related to the natural progression of disease); and (3) adverse drug withdrawal reactions (ADWEs) (i.e., a clinical set of symptoms or signs that are related to the removal of a drug) (Edwards and Aronson 2000; Hanlon et al. 2010). Besides death, which fortunately is rarely due to medications, one of the worst consequences of medication use in older adults is hospitalization. Studies have shown that up to 16 % of hospital admissions are due to ADRs, up to 11 % due to TFs, and approximately 1 % due to ADWEs (Beijer and de Blaey 2002; Kaiser et al. 2006; Marcum et al. 2011). Taken together, these medication-related problems are a significant cause of morbidity and mortality as well as unnecessary healthcare costs in older adults.