Inappropriate polypharmacy—the extreme or pointless use of a number of drugs—is a significant driver of emergency hospital admissions amongst adults aged 65 and over, in line with a brand new research from the College of Tub within the UK.
The researchers hope their findings will pave the best way for the event of a digital instrument—reminiscent of an app—to proactively determine older adults liable to medication-related hurt and intervene earlier than a hospital go to turns into obligatory.
The research—printed in Age and Ageing—is the primary of its type to make use of data-driven strategies to discover how doubtlessly inappropriate polypharmacy contributes to short-term hospitalization in older adults.
With this inhabitants rising quickly and going through elevated dangers of issues from being hospitalized, the findings reinforce considerations in geriatric care over the risks of overprescribing.
The hidden risks of overprescribing
Older adults typically take a number of drugs to handle power situations reminiscent of diabetes, hypertension and arthritis. This could result in prescribing cascades, the place unwanted effects from one drug are handled with extra drugs, making a cycle of escalating complexity and threat.
As an example, a affected person is likely to be prescribed a drug for ache administration, develop hypertension as a facet impact after which obtain one other remedy to handle that new symptom. Over time, this will result in a posh internet of prescriptions, carrying the danger of dangerous interactions.
Ph.D. researcher Robert Olender from the Division of Life Sciences at Tub, who led the research underneath the supervision of Dr. Prasad Nishtala and Dr. Sandipan Roy, stated, “With extra older adults on advanced drug regimens, we want proactive methods to scale back preventable emergency hospitalizations.”
Although the brand new analysis is concentrated on information from the UK, polypharmacy amongst older adults is understood to be a rising downside globally, with research from nations that embrace the US, Australia, New Zealand and throughout Europe constantly linking polypharmacy to elevated dangers of hospitalization, opposed drug reactions and lowered high quality of life.
In an earlier research primarily based on a New Zealand dataset, additionally carried out by the crew at Tub, a powerful correlation was present in older folks between a excessive drug burden, alcohol consumption and smoking with an elevated threat of 30-day hospitalizations.
Utilizing machine studying to foretell hospitalization
The research used a big UK dataset to develop three machine studying fashions able to predicting 30-day emergency hospitalization in older adults with round 75% accuracy.
A key variable in these fashions was the Drug Burden Index (DBI), which measures the cumulative impact of medicines with sedative and anticholinergic properties. Anticholinergics are a category of drug used to deal with varied power situations reminiscent of dementia, despair, urinary incontinence and power obstructive pulmonary illness (COPD).
The cumulative results of those medicine constantly emerged as one of many strongest predictors of an individual being liable to emergency hospitalization. Different predictors included impaired mobility, a historical past of fractures and falls, smoking and extreme alcohol consumption.
What makes this research distinctive is its deal with a beforehand underexplored dataset and age group, providing new insights right into a long-standing concern. Whereas the risks of polypharmacy are well-known, this analysis highlights the hyperlink between polypharmacy and short-term hospitalization. It additionally lays the groundwork for a possible instrument to determine at-risk sufferers and information them towards safer care.
From analysis to real-life affect
The analysis crew envisions an app for clinicians that makes use of a easy questionnaire to evaluate a affected person’s threat of hospitalization. Questions would possibly embrace present prescriptions, way of life elements (e.g. smoking and alcohol use) and power situations like most cancers or hypertension. The instrument would then generate a threat rating, permitting clinicians to make knowledgeable selections in actual time.
Such a instrument might function a low-cost, high-impact intervention to maintain sufferers protected and create financial savings for the NHS. By figuring out high-risk sufferers early, clinicians might regulate remedy regimens, encourage bodily exercise or tackle modifiable way of life elements—easy steps that would considerably scale back a person’s threat of an emergency hospital admission.
Whereas the app could possibly be developed comparatively shortly, integrating it into medical workflows would require regulatory approval and trials. Nonetheless, the potential advantages—fewer hospital admissions, improved affected person security, and lowered well being care prices—make this a compelling funding, the researchers consider.
The crew hopes such a instrument would increase consciousness amongst well being care professionals, notably these in main care, neighborhood pharmacies and hospices, the place early intervention might assist forestall emergency hospital admissions.
Mr. Olender stated, “As populations age worldwide, addressing inappropriate polypharmacy has turn out to be a key public well being precedence. Our new research contributes to the worldwide proof base by using superior data-driven strategies to achieve a deeper understanding of the size and penalties of this concern within the UK context.
“Our intention is to show the research’s findings into an impactful instrument to assist safer prescribing and enhance the care of older adults.”
Dr. Nishtala stated, “Inappropriate polypharmacy stays a worldwide concern, and the identification of constant threat elements throughout research highlights the timeliness and relevance of the present investigation.
“A instrument that helps assess the danger of hospitalization in older adults might carry actual advantages. It’d spare sufferers and their households the stress and disruption of a hospital keep, assist more healthy getting older by conserving folks out of environments the place they’re extra weak to infections and issues, and in the end assist the NHS save useful sources.”
Extra info:
Robert T Olender et al, Doubtlessly inappropriate polypharmacy is a crucial predictor of 30-day emergency hospitalisation in older adults: a machine studying function validation research, Age and Ageing (2025). DOI: 10.1093/ageing/afaf156
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Too many medicines, too many hospital visits: Research highlights hidden threat for older adults (2025, July 3)
retrieved 3 July 2025
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