The UFC Que Choisir analyzed nearly 350 prescriptions for seniors. Four out of ten prescriptions would be potentially dangerous. The association also denounces the over-prescription.
“Stop drug overdose for the elderly” is the title of the latest survey from theUFC-Que Choosing Health published this Wednesday. The investigators sifted through 347 prescriptions from people over the age of 75 taking multiple drugs (at least 5 prescription lines). In the end, 3,000 drugs were therefore reviewed to quantify the phenomenon of overprescription and its dangers. With results that are at the very least worrying.
Up to 21 drugs per prescription
The rates of inappropriate prescriptions indeed show overprescribing on the part of physicians. In this polymedicated population, the elderly are prescribed nearly 9 different drugs per day. The longest prescription even displays 21. Investigators wonder: “At these prescription levels, are doctors still able to ensure that each drug is justified and is not more dangerous than beneficial? ? And for them, their analysis clearly shows that it is not.
The survey reveals that 4 out of 10 prescriptions are potentially dangerous for elderly patients. In addition, more than one in 20 people are prescribed more than one inappropriate medication. Worse, on nearly 7% of prescriptions, 2, 3 or even 4 lines of inadequate prescriptions were detected.
Three classes of potentially inappropriate drugs are particularly common. These are sleeping pills and tranquilizers (1 out of 4 prescriptions), so-called “atropine” drugs such as antidepressants or antispasmodics (1 out of 10 prescriptions), and finally vasolidalators, indicated in the treatment of cognitive disorders (except dementia and Alzheimer’s ). For the latter, 1 in 20 prescriptions contains an inadequate prescription.
More serious side effects in older people
Faced with these figures, the UFC Que Choisir recalls that the correct prescription is a “particularly important” issue for the elderly. The association for the defense of consumers explains that as we age “the body becomes less and less able to eliminate the substances absorbed. Medicines therefore remain in larger quantities and longer in an aging organism. In addition, the side effects associated with taking a drug are often more serious for the elderly, more fragile. “
Deprescribing, a financial issue
Moreover, this overprescription also has a cost for our health system. Drug expenditure in France reached 33.5 billion euros in 2013, at nearly 90% for drugs reimbursable by health insurance.
When it comes to medicine, the French are greedy, with per capita consumption 22% higher than the average for large European countries (1).
To try to stop this spiral, Que Choisir therefore urges the public authorities to include “deprescribing” for the elderly in the indicators of remuneration based on public health objectives (ROSP). Since 2011, liberal doctors can, in fact, receive additional remuneration. This “performance bonus” is conditioned by several public health objectives which must be fulfilled by the attending physician (reduction of prescriptions for antibiotics or work stoppages, preference for generic drugs, etc.)
(1) Source: 2013 Health Accounts, IMS Health 2012 data. Consumption measured in standard units.
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