NEW YORK (Reuters Health) - The majority of elderly people in assisted-living or residential care facilities are not receiving all of the medications they need for four common conditions, according to new study findings released Monday.

Traditionally, experts have worried about medication overuse among elderly people. To investigate whether the elderly were also facing problems due to a lack of needed medications, Dr. Philip D. Sloane of the University of North Carolina in Chapel Hill and his colleagues reviewed the medical records of 2014 people 65 years of age or older.

All study participants were residents of assisted living or residential care facilities. Such residents tend to be less impaired than people living in nursing homes, but are still provided with 24-hour supervision and help with day-to-day activities.

Sloane and his colleagues found that among people with a history of heart attack, more than 60 percent were not taking aspirin, and three-quarters were not receiving beta-blockers, commonly used to prevent repeat attacks.

And among people with the bone-thinning disease osteoporosis, more than 60 percent were not taking calcium supplements, and more than half were given no treatment at all.

More than 60 percent subjects with congestive heart failure were not receiving an angiotensin-converting enzyme (ACE) inhibitor -- a common drug for this condition -- and more than one-third of stroke patients were not given drugs to prevent future blood clots, Sloane and his team report in the Archives of Internal Medicine.

"The absence of potentially beneficial treatments in such high percentages of residents of these facilities raises the specter of an important quality problem in the care of older patients," Dr. Jerry H. Gurwitz, told Reuters Health.

Gurwitz, who wrote an editorial about the study and is based at the Meyers Primary Care Institute, the Fallon Foundation and the University of Massachusetts Medical School in Worcester, added that many doctors hesitate to prescribe medications to the elderly because there is little information about drug safety in older populations. They may also fear the new prescription could interfere with seniors' often-complicated drug regimens.

Including more elderly, particularly people with several conditions, in drug studies might help address this problem, Gurwitz noted.

Meanwhile, he suggested that working with nurses and pharmacists may help doctors avoid either under- or over-treating their elderly patients.

SOURCE: Archives of Internal Medicine, October 11, 2004.

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