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.

All Australian hospitals are being accredited under The Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. Each of the ten standards relate to optimising clinical care and better outcomes for all patients. While identifying and responding to issues of medication safety (standard 4) is directly referred to within the NSQHSS, this topic highlights the need to approach the clinical issues older people face in hospital in a holistic and person-centred way in order to identify and respond to multiple modifiable risk factors throughout their stay. In addition to assisting us to meet Standard 4, this topic relates to preventing falls and harm from falls (standard 10) and to improving our identification and response to people presenting with or developing a cognitive impairment (Cognition Clinical Care Standard).