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The cost of medication-related problems in all age groups approaches $85 billion annually. The vast majority of these costs occur in people living in the community, while direct costs of medication-related problems amount to $4 billion in hospitalized patients and another $4 billion in nursing facility residents.

Two major studies cited in this report show that older Americans are especially vulnerable to dangerous medication interactions and medications or doses that are inappropriate because of age or disease burden.

A 1996 General Accounting Office report and another in November 1997 by the U.S. Department of Health and Human Services, Office of Inspector General, found approximately one-fifth of older patients are given medications considered by medical experts to be unsuitable for older people because of the high risk of unintended harm.

Even short of fatal side effects and toxicities, medications can cause disabilities, impair function, cause confusion, and reduce independence in older persons. Each year medications are implicated in tens of thousands of auto accidents, home injuries, falls, and fractures.

Nonetheless, medication-related problems continue to be under-studied and poorly understood. Relatively little research has been done to assess the full extent of the costs, both human and economic, of medication-related problems in the older population. There is an urgent need for further studies of medication effects in the over-65 population and even more urgently in the over-85 population.

Without more information--especially on medications intended to treat conditions commonly seen in older people--medication-related problems in the older population in the U.S. will only increase.

The Alliance for Aging Research has prepared a report ("When Medicine Hurts Instead of Helps:  Preventing Medication Problems in Older Persons") to stimulate debate and action on the issues surrounding medication-related problems in older people. The Alliance convened an expert panel from the fields of geriatrics, nursing, health care economics, and pharmacy.

The expert panel developed recommendations for researchers, health care organizations, and public policy makers. These recommendations are intended to encourage steps that will reduce health care costs, needless hospitalizations, additional disabilities, and lives lost due to medication-related problems in older people.