Saturday, 12 May 2012

Over-65s consume an average 8 medications a day

ANDALUCÍA One of the most troublesome problems for the Servicio Andaluz de Salud (SAS) regional health service is medication for the elderly. A new national law will oblige them to pay a proportion of the cost of their medicines, which up to now has been absolutely free. Much of the medication at this age is prescribed for life, but another underlying reason is that formal education in the age bracket is often deficient because of circumstances such as the aftermath of the Civil War and 'the hunger years' of the 1950s and 60s, when education was in many cases put aside for work, particularly in rural communities such as Andalucía. This translates into the difficulty doctors have in prescribing generic, active-principle medicines to the elderly, who are accustomed to PLEASE BE AWARE THAT ITEMS SUCH AS THIS MAY BE SUBJECT TO SUBSCRIPTION IN THE FUTURE but you can make a donation NOW, too! Please click here for more information on how to help us continue. This article took two hours and seventeen minutes to research, write, illustrate and publish.>>>
their branded medication and are very reluctant to change, as they are already expected to do in Andalucía and other communities and the new national laws are put into practice.

Behind that is the fact that universal health care is relatively new in Spain, having not come properly into being until the 1980s. Moreover, Andalucía is based largely on a rural economy where the health (and education) of the population has for a very long time been put aside by successive governments in favour of other more 'modern' things.

In any case, this age bracket is a large-scale consumer of medication against ills such as high blood pressure, inflammation of the joints, aches & pains and pulmonary obstruction, among others, according to a study carried out in the Primary Care Districts of Sevilla and Jerez-Northwest Coast.

An analysis of 2,919 medical histories of over-65s in 14 health centres reveals, among many other things, that Andalucía is not very different from other regions and even countries where similar studies have been carried out. The phenomenon of what the study calls 'poli-medication' is common to most if not all.

An excessive intake of medication is apparently associated to a larger risk of falls among the elderly, plus the possibility that the patient can, and often does, make mistakes in dosage or frequency of the prescribed medicines. This is exacerbated by the implantation of the SAS's requirement that branded medication be replaced by a generic, cheaper substitute (as long as the same active-principle is present in the same amounts), which in itself causes confusion, particularly among a patient base that frequently has difficulty reading. However, this is not the main reason for 'poli-medication', according to the study.

"Poli-medication is associated with the very need to use a multiplicity of medicines, but does not depend on each prescription per se," according to Teresa Molina, who headed the investigation. The study also reveals that poli-medication is prevalent in 49.6% of the medical histories studied, which extrapolates into that part of the population that takes 8.7 medicines every day. But it is also true that 80% of the patients were included in the cardio-vascular high-risk bracket that is notoriously difficult to prescribe accurately for from the beginning of its onset, and requires much trial and error.

Big differences among health centres
More revealingly however, is the differences in poli-medication among health centres: in some Primary Care centres poli-medication is detected in 33% of cases, while in others it is as high as 89%.

But the study does not look into the causes of these vast differences, though Molina points out that it is possible that there is a considerable difference in ages among the areas covered by different centres. Nor does the study say whether there is over- or under-consumption of medications. That, says Molina, is for a study aimed at those variables specifically.

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