An international survey of more than 10,000 adults age 65 or older has found that more Americans had multiple chronic conditions and took four or more prescription drugs than their age mates in 10 other countries.
The survey, the results of which were published in a paper in the December issue of the journal Health Affairs, found that 68 percent of Americans surveyed suffered from two or more chronic conditions; the highest figure among the 11 countries in the study. At 53 percent of those surveyed, the U.S. also topped the list in number of older individuals taking four or more prescription medications.
Researchers polled just more than 15,000 people aged 65 and older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the U.S.
Chronic conditions are a widespread problem in the U.S. According to the Centers for Disease Control and Prevention (CDC), about half of all adults are now living with at least one chronic medical condition, while one in four have multiple. The CDC also reports that seven of the top ten causes of death in 2010 were from chronic conditions and that the majority of U.S. healthcare costs are associated with chronic diseases.
Since suffering from multiple chronic conditions and taking multiple drugs typically go hand in hand, this places older Americans at an increased risk for drug-drug, drug-gene or cumulative interactions compared to their international peers. Increased risk of interactions could result in adverse drug events and treatment failures.
Americans were also the most likely (19 percent) to report having any cost-related health care access problems in the last year, according to the international survey results. At 10 percent, New Zealand had the second-highest number of residents reporting this problem. The U.S. also topped the list for older individuals (11 percent) who said they had problems paying or were unable to pay medical bills in the last year.
The survey also shed light on some positive healthcare trends for older Americans. U.S. respondents were among the most likely to have discussed health-promoting behaviors with a clinician (76 percent), to have a chronic disease plan tailored to their daily life (58 percent), and to have engaged in end-of-life care planning (55 percent).
A common theme among the survey findings, the study authors report, was a lack of coordinated care on the part of providers.
“While each of the health care systems in the surveyed countries has its strengths, all countries surveyed have room for improvement,” the study authors conclude.
“No health system consistently offers older adults accessible, coordinated, and patient-centered care.”
With the health of a particularly vulnerable and growing older population at stake, care coordination is a topic healthcare providers should keep at the forefront. The American Geriatrics Society offers an overview of care coordination for the elderly on their website.