Three-quarters of older Americans have multiple chronic health conditions, and more than 1 in 5 are being treated with drugs for some of those problems that may make the others worse, new research shows.
The treatment of multiple conditions at once — even if those treatments might conflict with one another — is common in American medicine, experts say. That's because doctors may not communicate with one another and little information exists to help practitioners weigh competing alternatives and identify different options.
Consequently, many seniors take many drugs that work at odds with one another, said Oregon State University researchers who helped conduct the new study, funded by the National Institutes of Health.
"Many physicians are aware of these concerns but there isn't much information available on what to do about it," said David Lee, an assistant professor with the OSU/Oregon Health & Science University College of Pharmacy.
"Drugs tend to focus on one disease at a time, and most physicians treat patients the same way. As a result, right now we're probably treating too many conditions with too many medications. There may be times it's best to just focus on the most serious health problem, rather than use a drug to treat a different condition that could make the more serious health problem even worse."
The new study — by researchers from OSU and the Yale University School of Medicine — involved 5,815 men and women who were tracked between 2007 and 2009. The study identified several common competing chronic conditions, in which medications for one condition may exacerbate the other. They included diabetes and coronary artery disease, as well as high blood pressure and osteoarthritis, diabetes, chronic obstructive pulmonary disease (COPD), and depression — conditions that affect millions of older Americans.
The results, published in the Public Library of Science journal PLOS ONE, showed that 22.6 percent of the study participants received at least one medication that could worsen a coexisting condition.
For example, patients who have coronary heart disease are often treated with beta blockers, but those drugs can cause airway resistance that worsens COPD — so a patient with both conditions may suffer as a result of such treatment.
"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. "It's this type of information that would be of value in addressing these issues if it were more widely known and used."
Jonathan Lorgunpai, a medical student at the Yale School of Medicine and co-author of the study, said the findings suggest more than 9 million older Americans are being prescribed medications "that may be causing them more harm than benefit. Not only is this potentially harmful for individual patients, it is also very wasteful for our healthcare system."
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