Children and seniors swallow too many pills

German children and seniors swallow too many pills

06/12/2013

The Barmer GEK published yesterday on Tuesday the Drug Average Report 2013, the data of 2.1 million insured over a period of 65 years evaluates. „We have found many reasonable care structures. We have also found the application of many useful and safe medicines, but we have also found over- and misuse.“, Healthcare researcher Prof. Gerd Glaeske summarizes the findings of the study. The biggest problems in the German pharmaceutical landscape are, on the one hand, the polypharmacy of older insured persons and, on the other hand, the increased prescription of antipsychotic drugs among children and adolescents.

Older people suffer from polypharmacy
Polypharmacy is mentioned when more than five active pharmaceutical ingredients are used daily. According to the Arzneimittelreport 2013, this problem affects one third of all insured persons. Among the elderly, aged 80 to 94, half are affected. „On average, men over the age of 65 take 7.3 drugs daily, compared to 7.2 women in this age group“, writes the Barmer GEK. Glaeske emphasizes: "In pharmacology, we say that you can tolerate three to four drugs relatively well."

The reason for this oversupply is the fact that over 65-year-olds had an average of four doctors: a GP, an ophthalmologist, an orthopedist, a gynecologist in women and a urologist in men. They would each prescribe several medications. Polypharmacy is so far „an indication that there is a regular lack of coordination between physicians“, explains Glaeske.

According to Rolf-Ulrich Schlenker, Deputy CEO of Barmer GEK, risky multimedia could be prevented by electronic means. He emphasizes: „We urgently need the electronic insurance card. We urgently need the electronic prescription. And we also urgently need the electronic patient card.“ His criticism applies in particular to officials of the medical profession who have resisted its introduction for years. They should finally give up their negative attitude, so Schlenker. „It must finally be over with the blockade policy of well-known medical officials against a modern telematics infrastructure“, also writes the Barmer GEK. She recommends older people „to have their medicines tested for interactions at the pharmacy“.

Taking antipsychotic drugs in children increases dramatically
The development of the prescription numbers of antipsychotic drugs in children and adolescents seems equally dramatic. They rose by 41 percent between 2005 and 2011, the Drug Report 2013 determined. „The growth is mainly due to newer preparations (+ 129 percent)“, By contrast, the numbers of older drugs have declined slightly. A closer look at the affected age groups shows a clear picture: „In infants under four years, doctors hardly prescribe antipsychotics. For all others, the prescription figures are rising, most of the 10- to 14-year-olds“, so the Barmer GEK. This increase is particularly problematic because, according to Glaeske, no medical explanation can be derived. Barmer GEK explains: „Studies have not shown an increase in psychiatric disorders in children and adolescents, nor have the relevant treatment recommendations changed.“

„And if that does not work with the Retalins and similar medicines alone, then you suddenly seem to add very strong sedatives“, Glaeske tries to explain. In this way, they want to adapt the children to the social context in which they live. The problem is that some antipsychotic drugs have serious side effects. According to Glaeske, these include headaches, insomnia and weight gain. In addition to psychotropic drugs, one-third of children also receive remedies for ADHD, despite little serious diagnoses - an inexplicable problem for the researchers involved.

Pharmaceutical companies refer to PRISCUS list and FORTA classification
The Association of Research-Based Pharmaceutical Companies counters these allegations. The increasing risk of illnesses such as high blood pressure, stroke or osteoporosis due to age causes the greater number of medical treatments, it says in a statement. „For the patients, it is a blessing that these diseases can now be treated with medication or prevented.“ However, the pharmaceutical association also points out that a particularly high level of care is required in older people. „The concomitant use of several medications must be carefully planned so as to avoid unavoidable drug-drug interactions that cause the therapy to be inadequate or poorly tolerated.“

Often possible interactions of the „Active principles and degradation processes of the drugs“ as another measure, these would be tested in clinical trials. Moreover, the interactions that occur are usually known interactions, only „rarely are they unknown in medicine effects“. To help physicians treat elderly patients, physicians also created tools such as the PRISCUS list and the FORTA classification. „Both remedies are designed to help older patients receive good treatment and avoid unnecessary risks.“ The pharmaceutical association hopes that these tools will be used more in the future. (Lb)