While hospitals can be lifesavers, especially for the elderly, an alarming number of older patients fail to continue taking their regular medications after they return home—particularly if they spent time in intensive care. Why? Mainly because they neglect to renew their prescriptions.

Researchers at Toronto's St. Michael's Hospital examined data on almost 400,000 people living in Ontario between 1997 and 2009. They were all over the age of 66 and were regularly taking one of five medications commonly used to treat chronic conditions-statins for lowering cholesterol, anti-clotting drugs, thyroid replacement hormones, respiratory inhalers, and drugs that suppress gastric acid. During that time, slightly fewer than half of the study participants were hospitalized for unspecified conditions, and less than 10 percent of those were admitted to the ICU. What the researchers found is that admittance to a hospital resulted in patients being less likely to renew a long-term prescription. Almost one-fifth of patients did not renew their medications after discharge. Being admitted to the ICU carried an even higher risk-almost one-quarter of ICU patients failed to renew medications after discharge.

Why do so many seniors neglect their medications once discharged from the hospital, particularly if they were in the ICU? The study's lead researcher, Dr. Chaim Bell, said in a statement that the reason may be that ICUs are focused on treating acute illnesses, not chronic conditions. It's not uncommon for a long-term medication to be temporarily discontinued as the critical-care staff deals with a more pressing problem. Regular prescriptions "may later be forgotten or overlooked upon discharge," Bell said. He also noted that ICU patients are typically sent to a regular hospital bed once the emergency is over, and this handoff presents another opportunity for miscommunication and error.

The problem with seniors forgetting to take long-term medications is that the diseases for which the medications are intended are still present and causing damage. Patients who suspend their prescriptions are at increased risk of being readmitted to the hospital. That's why it's a good idea for senior citizens to keep a record of all prescriptions in one handy place. If one medication is temporarily suspended, the patient can review the list with his or her doctor upon discharge and make sure there are fresh prescriptions for everything needed.



St. Michaels Hospital, Toronto, www.stmichaelshospital.com
Journal of the American Medical Association, www.jama.ama-assn.org.