Medicine use in older people is complex and highly individual. It needs to be monitored and managed to avoid errors and adverse effects and to help older people get the best outcomes from medication use.
As we get older, physiological changes can affect our metabolism, making it more likely that we will experience adverse reactions and side effects from medications. With age, we are more likely to have multiple medical conditions and be taking multiple medications, which puts us at higher risk of falls, delirium, hospital admissions, declining nutritional status, decreased physical and social functioning and death.
The ability to manage complex medication routines is influenced by a person’s level of social support and connectedness, with lower levels of support being associated with higher medication use.1 If we understand a patient’s circumstances we can help them to manage their medications successfully.
Up to 30 per cent of hospital admissions for patients over the age of 65 are medication related and half of these are potentially preventable.2
This topic gives an overview of issues around medication use in older people. It recommends actions that we and our organisations can take to ensure older patients have an effective medication regime that they can manage.
In addition to following your health service specific policy and procedures, consider the recommended actions and discuss them with colleagues and managers.
1. Bath P.A. and A. Gardiner, Social engagement and health and social care use and medication use among older people. European Journal of Ageing, 2005. 2: pp. 65-63.
2. Roughead, E.E., Semple, S.J., Medication Safety in Acute Care in Australia: Where Are We Now? Part 1: A Review of the Extent and Causes of Medication Problems 2002–2008, Australia and New Zealand Health Policy 2009, 6: p. 18.
Medication and ageing
Medicines can be problematic for older people because ageing can affect the way our body absorbs, distributes, metabolises and eliminates drugs.
Identifying medication risks and issues
A patient is considered at risk of medication issues if they are aged over 65 years and their medication history and use should be assessed
Optimising medication use
There are several things we can do to support an effective medication regime to optimise outcomes for older people while they are in hospital.
Medication and discharge planning
To reduce the risk of medication errors and misunderstandings, provide comprehensive and clear information about medication and medication use on discharge.
Further information - medication
Educational and information resources available on assessing and managing medication use in older people in hospital.
All public and private hospitals are required to be accredited to the Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. The primary aims of the standards are to protect the public from harm and to improve the quality of health service provision. Assessment to the second edition of the NSQHS Standards commenced in January 2019. The second edition comprises eight standards that provide a nationally consistent statement about the level of care consumers can expect from health services.
The Comprehensive Care Standard (Standard 5) aims to ensure that patients receive comprehensive health care that meets their individual needs, and considers the impact of their health issues on their life and wellbeing. It also aims to ensure that risks of harm for patients during health care are prevented and managed through targeted strategies. These include integrating patient care processes to identify patient needs and identifying actions related to falls, pressure injuries, nutrition, mental health, cognitive impairment and end-of-life care.
Information is presented in the Older People in Hospital learning topics that complements Standard 5 and other NSQHS Standards including the; Partnering with Consumers Standard (Standard 2), Medication Safety Standard (Standard 4), Communicating for Safety Standard (Standard 6) and Recognising and Responding to Acute Deterioration (Standard 8).
Reviewed 10 November 2021