Risk of Adverse Effects Lessens Drug Acceptance in Elderly

Elderly likely to accept drugs with only mild benefits, but less so with adverse effect risk

WEDNESDAY, March 2 (HealthDay News) -- The willingness to take medication for primary cardiovascular disease prevention in older persons is highly sensitive to its adverse effects and relatively insensitive to its benefits, according to a study published online Feb. 28 in the Archives of Internal Medicine.

Terri R. Fried, M.D., from Yale University School of Medicine in New Haven, Conn., and colleagues interviewed 356 community-living older persons to measure their willingness to take medication to prevent myocardial infarction (MI) according to its benefits (absolute five-year risk reduction) and risks (type and severity of adverse effects).

The investigators found that 88 percent of the participants were willing to take medication if the benefit approximated the average risk reduction of currently available medications (absolute benefit of six fewer persons with MI out of 100). Most of these (82 percent) remained willing to continue when the absolute benefit was decreased to three fewer persons with MI. Of the unwilling participants, 17 percent indicated they would be willing to take the medication if the absolute benefit was increased to 10 fewer persons with MI. Adverse effects, such as feeling mildly tired, nausea, or cloudy thinking, caused large proportions (48 to 69 percent) of the participants to report their unwillingness or uncertainty in taking medications that have an average benefit. Only 3 percent of participants said they would take a drug with adverse effects that could impact on functioning.

"These results suggest that clinical guidelines and decisions about prescribing these medications to older persons need to place emphasis on both their benefits and harms," the authors write.

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