Drugs poisoning elderly patients, says NHS expert

Elderly people are being “poisoned” by overdoses of medication because drug trials are carried out on younger people, an NHS expert has warned.

Sir Munir Pirmohamed, NHS chairman for pharmacogenetics, said older people were in danger of toxicity because their ageing bodies could not process powerful pills.

ELDERLY people are being “poisoned” by overdoses of medication because drug trials are carried out on younger people, an NHS expert has warned.

Sir Munir Pirmohamed, professor of molecular and clinical pharmacology at Liverpool University and NHS chairman for pharmacogenetics, said older people were in danger of toxicity because their ageing bodies could not process powerful pills.

Many pensioners are also taking 10 to 20 different types of medication for multiple conditions, leaving them at risk of dangerous adverse reactions between the drugs.

Speaking at a House of Lords science and technology committee looking at ageing, Sir Munir said: “Most drugs have been tested in younger people, and tested in people without multiple diseases. When we use a drug at a dose that is licensed, we’re often poisoning the elderly because of the doses we are using.

“This is largely because as you get older, renal function declines and you also have drug interactions.

“Most patients I see now are on 10, 15, 20 drugs, and that means you get three, four, five-way interactions, so drug reactions are common in this group and they’re often not picked up in clinical care.

“It’s very easy to prescribe drugs, but it’s very hard to stop drugs. When someone is taking 15 drugs, it is very difficult to decide which should be stopped.”

The committee heard nearly one in 15 people in NHS hospitals are there because of adverse drug reactions, meaning around 8,000 beds are occupied because of drug failures at any one time, costing the NHS £1.6billion.

Previous research has shown that more than half of people in falls clinics will be taking a medication which contributes to their risk of falling.

Likewise, nearly 50 per cent of people admitted in a state of delirium will be taking drugs with side effects that exacerbate the condition.

Prof Miles Witham, the national lead for ageing at the National Institute for Health Research (NIHR), said regulations needed to change to force pharmaceutical companies to conduct trials that involved elderly people and those with multiple conditions.

“There was a perception that older people were messy and spoil nice clean trials because a lot of stuff happens to older people – they get ill, sometimes they die, or they find it difficult to come to appointments,” he said.

“In the real world people with heart failure have a common age of 85, but in clinical trials the average age is 65 and that gap is extremely common whichever disease you look at.

“The evidence we gain from clinical trials is actually not fit for purpose in many cases because it doesn’t apply to the people we are giving treatment to.”

Prof Witham said the NIHR was running projects in Newcastle to allow people who were housebound or live in care homes to take part in trials.

“We need to do more of that because older people have been neglected in clinical trials,” he added.

‘There was a perception that older people spoil nice clean trials because a lot of stuff happens to them’