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Concurrent use of alcohol interactive medications and alcohol in older adults

Older adults are susceptible to adverse effects from the concurrent use of medications and alcohol. A study aimed to systematically review the prevalence of concurrent use of alcohol and alcohol-interactive (AI) medicines in older adults and associated adverse outcomes.

A systematic search was performed to identify relevant observational studiesand twenty cross-sectional, were included. Nine of the studies classified a wide range of medicines as AI using different medication compendia, thus resulting in heterogeneity across studies. Three studies investigated any medication use and eight focused on psychotropic medications.

The most reliable estimate of concurrent use in older adults ranged between 21 and 35%. The most reliable estimate of concurrent use of psychotropic medications and alcohol ranged between 7.4 and 7.75%. None of the studies examined longitudinal associations with adverse outcomes. Three studies reported on falls with mixed findings, while one study reported on the association between moderate alcohol consumption and adverse drug reactions at hospital admission.

The authors conclude that although there appears to be a high propensity for alcohol-medication interactions in older adults, there is a lack of consensus regarding what constitutes an AI medication. They suggest that an explicit list of AI medications needs to be derived and validated prospectively to quantify the magnitude of risk posed by the concurrent use of alcohol for adverse outcomes in older adults. This will allow for risk stratification of older adults at the point of prescribing, and prioritise alcohol screening and brief alcohol interventions in high-risk groups.

Source: Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes. Holton AE, Gallagher P, Fahey T, Cousins G. BMC Geriatr. 2017 Jul 17;17(1):148.

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