	Inappropriate Use of Prescription Drugs Is a Major Health Problem for the Elderly

The inappropriate use of prescription drugs is a problem that is particularly acute for the elderly. Inappropriate Prescription Drug Use Is Widespread Among the Elderly

Based on 1987 data from the National Medical Expenditure Survey, a research study published in July 1994 concluded that almost 25 percent of the noninstitutionalized elderly 65 or older used prescription drugs at least once during the year that are generally considered unsuitable for their age group. Our analysis showed that an estimated 17.5 percent of the almost 30 million senior citizens in the survey used at least one of these drugs in 1992. The Elderly Are Particularly Vulnerable to Inappropriate Prescription Drug Use

The elderly are more likely than other segments of the population to be affected by the inappropriate use of prescription drugs. Elderly patients often lack the ability to eliminate drugs from their systems as efficiently as younger patients do because of decreased liver and kidney function. Since the elderly are more vulnerable to the effects of the inappropriate prescription drug use, they are at greater risk from adverse drug reactions than other segments of the population. 1.) Better Physician Education Can Improve Poor Prescribing Practices

The medical community has only recently started to emphasize the study of geriatrics and elderly clinical pharmacology. Most states have expanded that requirement to mandate drug utilization review of all prescriptions. To determine how physicians, pharmacists, and patients receive information on drug therapies, we identified actions that drug manufacturers and FDA have taken to provide better dosage information for elderly patients as well as changes in how drug manufacturers disseminate information to physicians, pharmacists, and patients. To identify emerging trends in the health care delivery system and their potential effects on the inappropriate use of prescription drugs, we obtained information on how managed care plans develop formularies, train their staff on new drug therapies, and track both patient and physician use of prescription drugs. 2, No. 4 (Apr. 4 (Apr. 2, No. Address Correction Requested
Why GAO Did This Study

Pursuant to a congressional request, GAO examined the elderly's inappropriate use of prescription drugs, focusing on: (1) whether the inappropriate use of prescription drugs by the elderly is widely viewed as a serious health problem; (2) the ways prescription drugs are used inappropriately and why these situations occur; (3) how public knowledge of prescription drugs can be improved; and (4) how emerging trends in health care delivery affect drug prescribing for the elderly.

What GAO Found

GAO found that: (1) the inappropriate prescription drug use is a serious health risk for the elderly, since they take more prescription drugs than other age groups, they often take several drugs at once, resulting in adverse drug reactions, and they do not efficiently eliminate drugs from their systems due to decreased body function; (2) the percentage of Medicare recipients over 65 using unsuitable prescription drugs dropped from 25 percent in 1987 to 17.5 percent in 1992; (3) inappropriate prescription drug use results from physicians using outdated prescribing practices, pharmacists not performing drug utilization reviews, and patients not informing their physician and pharmacist of all the drugs they are taking; (4) to address the problem of inappropriate prescription drug use, the government is working to disseminate information on the effect of prescription drugs on the elderly, the medical community is working to increase physicians' knowledge of geriatrics, and patients are increasingly seeking information about their drug therapies; and (5) enrollment in managed care plans has grown rapidly, particularly among senior citizens, allowing for the potential to improve the coordination of drug therapies for newly enrolled elderly patients.