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In addition to distress and potential dangers to patients, the problem is costing the NHS in England almost £400m annually in additional treatments and readmissions.

The research showed patients suffered a range of conditions including serious kidney injury, psychological disturbance, irregular heart rhythms, and researchers called for more awareness among clinicians of the harm that medicines can causes.

The study, conducted by (BSMS), run jointly by the universities of Brighton and Sussex, and King’s College London, has been published in the British Journal of Clinical Pharmacology: .

© Joshua Coleman

Research was conducted in five hospitals in the south of England and involved 1,280 patients with an average age of 82.

The study, the first of its kind, investigated the burden of medication-related harm in the eight weeks post-hospital discharge.

It found that more than one-in-three patients experienced harm from their medicines within two months of hospital discharge and that the problems were potentially preventable in half of the cases.

Medication-related harm was most commonly found to occur from the toxicity of the medicine itself and in a quarter of cases from poor adherence.

Medicines posing the highest risk were opiates, antibiotics and benzodiazepines. Patients suffered kidney injury, psychological disturbance, irregular heart rhythms, confusion, dizziness, falls, diarrhoea, constipation and bleeding.

Professor Chakravarthi Rajkumar, Chair of Geriatrics and Stroke Medicine at BSMS, and senior author, said: “As the use of medicines in the ageing population is rapidly increasing, it is vital that we improve awareness among clinicians of the harm that medicines commonly cause. The risk-to-benefit analysis is particularly complex in the older population. Once medicine is initiated, there should be a tentative stop date, monitoring of correct usage and vigilance for adverse reactions.

When a patient is due for surgery, full informed consent is taken after the risks and benefits are clearly discussed. Medication-related harm can be life-threatening and similarly decisions to prescribe high-risk medicines should be taken after a comprehensive discussion with the patient. While the cost implications are significant, the magnitude extends beyond finances to adversely affect the quality of life for patients and families.”

The study found there was a substantial use of NHS services attributable to the medication-related harm. Four out of every five patients who experienced harm then utilised NHS services, and eight per cent of patients were readmitted to hospital as a consequence. Based on these results, the estimated cost to the NHS in England is £396 million annually.

Professor Chakravarthi Rajkumar

Dr Khalid Ali

Professor Graham Davies, Professor of Clinical Pharmacy and Therapeutics at the Institute of Pharmaceutical Science, King’s College London and senior author, said: “In order to reduce the number of older people being harmed by their medicines, it’s important that their medication regimens are closely monitored within the community. Pharmacists should work in close collaboration with all prescribers to support the safe use of medicines.”

Dr Khalid Ali, Senior Lecturer in Geriatrics at BSMS and Chief Investigator of the study, added: “Supporting health literacy within the older population, specifically in terms of medication usage, is crucial. There is also an increasing volume of work on the potential benefits of ‘deprescribing’ medicines in older adults, whereby medications are reduced safely in a way that is acceptable to patients.”