[Over-consumption of drugs by elderly patients]

Aging is a major factor in the over-consumption of drugs: although individuals aged >65 years account for approximately 15% of the population, almost one-third of all prescriptions are made out for this age group. This over-consumption is responsible for a number of potential hazards, such as iatrogenic pathology, poor compliance and drug interactions; it is also an economic burden. Most studies report an average of five drugs prescribed per individual, regardless of outpatient or inpatient status. Cardiovascular and psychotropic drugs are the most widely prescribed classes. Analgesic and nonsteroidal anti-inflammatory drugs are also very common. These are also the classes responsible for the highest number of adverse events in the elderly. There are numerous reasons for this over-consumption; in some cases, it is attributable to the patient himself (multiple diseases, deterioration of bodily functions, poor compliance, misuse, etc.), while in others, the prescribing physician, family or professional caregivers are at fault. The development of new drugs and the information made available regarding them can also be implicated. Studies comparing actual prescriptions with reference indications have shown that some are inappropriate: one meta-analysis showed that for 21.3% of patients in institutions and 40% of patients in convalescent homes, at least one prescription was inadequate; and in another analysis, the same applied to 12.5% of patients living at home. The potential seriousness of this over-consumption by elderly patients, even more so than in adults, calls for a detailed analysis of the situation and rational, regularly reviewed, realistic prescribing.