How to reduce the over-prescription of unnecessary treatments in the elderly

How to reduce the over-prescription of unnecessary treatments in the elderly

Older patients are often excluded from clinical trials, with the result that much remains unknown about how they are affected by medications. Now, Swiss researchers are leading an EU-funded project to understand how to reduce the over-prescription of unnecessary treatments in the elderly.

“More than 60% of patients aged 65 and older admitted to the hospitals have polypharmacy,” says Nicolas Rodondi, a professor of internal medicine at Bern University Hospital, referring to the medical term for multiple drug prescriptions.

Some studies have found that roughly 30% of hospital admissions and 20% of unnecessary healthcare costs in the elderly are the result of duplicative, unnecessary, or otherwise inappropriate drug prescriptions.

“We find ourselves in a situation where lives last longer with every decade,” says Jürg Schlup, president of the Swiss Medical Association. “People also stay healthier thanks to improvements in the medical management of chronic diseases. It is here that we are confronted with the danger of over-medicalisation.”

Optimising therapy

Earlier this year, Rodondi and a team of experts from six EU countries responded to a call from the European Commission Horizon 2020 research framework to investigate the problem of over-medicalisation in the elderly. They received a total of €6.6 million in funding from the European Commission and from Switzerland’s State Secretariat for Education, Research and Innovation (SERI) to develop a software programme that will generate personalised medical recommendations for elderly patients.

The OPERAM study (OPtimising ThERapy to prevent Avoidable hospital admissions in the Multimorbid elderly) is the first health-oriented Horizon 2020 project to be led by Switzerland. It will focus on 1,900 patients aged 75 and older from all participating countries.

The researchers are developing software to identify medications that may be inappropriate for elderly patients, either because there is no specific indication for them, because they interact negatively with other drugs, or because an incorrect dosage has been prescribed.

The work could also reveal whether important medications are missing from a patient’s healthcare plan.

“We designed a trial to test whether a combination of interventions could not only decrease polypharmacy, but also improve clinical outcomes in the elderly – for example, by reducing the number of hospitalisations, and by increasing patient quality-of-life,” Rodondi explains.

Rodondi and his team hope that in addition to improving patient lives, the OPERAM project will save each participating country millions each year in healthcare costs.

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