Seoul National University Bundang Hospital (SNUBH) has announced research findings that the use of five or more drugs and inappropriate medications among older adults in Korea is increasing annually, leading to a significant rise in the risk of death or disability.

The research team at SNUBH, led by Professor Kim Sun-wook specialized in acute inpatient care and geriatric perioperative care, undertook a comprehensive study involving 3.3 million individuals aged 66 who underwent health examinations from 2012 to 2021. The collaboration extended to the active participation of the National Evidence-based Healthcare Collaboration Agency (NECA) and Asan Medical Center (AMC).

Based on the study findings, it was revealed that around 35.4 percent (roughly 160,000 individuals) of 66-year-olds consumed five or more medications consistently for over 90 days in 2021. This marked a notable rise from the 32 percent reported in 2012. Additionally, the percentage of individuals taking 10 or more medications in 2021 reached a substantial 8.8 percent.

The study underscored the importance of exercising caution as the number of medications prescribed increased. This escalation poses potential risks that may outweigh the benefits, because of factors such as physiological aging, drug interactions, and the interplay between medications and existing health conditions, the research team said. 

Additionally, the research pointed out that the habit of taking multiple medications increases the probability of receiving prescriptions for drugs that are deemed unsuitable for older adults.

Within the 66-year-old demographic, 53.7 percent were using at least one type of inappropriate medication, averaging 2.4 medications per individual.

While the proportion has remained consistent with that of a decade ago, the absolute number has surged by approximately 80 percent, escalating from 138,000 to 248,000.

Examples of inappropriate medications for older adults encompass esomeprazole magnesium (a digestive ulcer drug) and rabeprazole sodium (an acid secretion inhibitor). These medications may yield more adverse side effects than benefits in this demographic.

In a five-year follow-up study involving 650,000 66-year-olds who were prescribed these inappropriate medications, the findings indicated a 25 percent rise in mortality risk. Furthermore, there was a 46 percent higher likelihood of receiving a long-term care grade of 3 or higher, signifying a disability that necessitates assistance in daily life.

Moreover, the study demonstrated that the risk of disability increases by approximately 31 percent with the use of up to two inappropriate medications. However, this risk surges to 81 percent with the use of three or more inappropriate medications, underscoring that the risks escalate with the number of inappropriate medications employed.

The characteristics of the subjects revealed that individuals residing in smaller cities or suburbs, as opposed to larger metropolitan cities, medical aid recipients versus health insurance subscribers, and patients with multiple comorbidities, frequent hospital or emergency room visits, or visits to multiple medical institutions, exhibited higher counts of medications and inappropriate medication prescriptions.

"We found that even among older adults as young as 66 who are just entering their senior years, many are using multiple and inappropriate medications, which can lead to an increased risk of death or long-term care," Professor Kim said.

Professor Jung Hee-won at AMC also said, "Potentially inappropriate medication use in older adults may contribute to long-term functional decline, with adverse drug reactions serving as the initial link in a prescription chain that ultimately leads to increased healthcare utilization and additional prescriptions.”

Jung added that it is essential to raise awareness among both healthcare users and healthcare providers.

Researcher Yoon Ji-eun at NECA mentioned, "We hope the research will be used as evidence to establish policies to reduce inappropriate medication use in older adults."

The research team presented the study during the 2023 fall conference of the Korean Geriatrics Society on Nov. 25.