Inappropriate polypharmacy—the excessive or unnecessary use of multiple medications—is a major driver of emergency hospital admissions among adults aged 65 and over, according to a new study from the University of Bath in the UK.
The researchers hope their findings will pave the way for the development of a digital tool—such as an app—to proactively identify older adults at risk of medication-related harm and intervene before a hospital visit becomes necessary.
The study—published in Age and Ageing—is the first of its kind to use data-driven methods to explore how potentially inappropriate polypharmacy contributes to short-term hospitalization in older adults.
With this population growing rapidly and facing increased risks of complications from being hospitalized, the findings reinforce concerns in geriatric care over the dangers of overprescribing.
The hidden dangers of overprescribing
Older adults often take multiple medications to manage chronic conditions such as diabetes, hypertension and arthritis. This can lead to prescribing cascades, where side effects from one drug are treated with additional medications, creating a cycle of escalating complexity and risk.
For instance, a patient might be prescribed a drug for pain management, develop high blood pressure as a side effect and then receive another medication to manage that new symptom. Over time, this can lead to a complex web of prescriptions, carrying the risk of harmful interactions.
Ph.D. researcher Robert Olender from the Department of Life Sciences at Bath, who led the study under the supervision of Dr. Prasad Nishtala and Dr. Sandipan Roy, said, “With more older adults on complex drug regimens, we need proactive ways to reduce preventable emergency hospitalizations.”
Though the new research is focused on data from the UK, polypharmacy among older adults is known to be a growing problem globally, with studies from countries that include the US, Australia, New Zealand and across Europe consistently linking polypharmacy to increased risks of hospitalization, adverse drug reactions and reduced quality of life.
In an earlier study based on a New Zealand dataset, also carried out by the team at Bath, a strong correlation was found in older people between a high drug burden, alcohol consumption and smoking with an increased risk of 30-day hospitalizations.
Using machine learning to predict hospitalization
The study used a large UK dataset to develop three machine learning models capable of predicting 30-day emergency hospitalization in older adults with around 75% accuracy.
A key variable in these models was the Drug Burden Index (DBI), which measures the cumulative effect of medications with sedative and anticholinergic properties. Anticholinergics are a class of drug used to treat various chronic conditions such as dementia, depression, urinary incontinence and chronic obstructive pulmonary disease (COPD).
The cumulative effects of these drugs consistently emerged as one of the strongest predictors of a person being at risk of emergency hospitalization. Other predictors included impaired mobility, a history of fractures and falls, smoking and excessive alcohol consumption.
What makes this study unique is its focus on a previously underexplored dataset and age group, offering new insights into a long-standing issue. While the dangers of polypharmacy are well known, this research highlights the link between polypharmacy and short-term hospitalization. It also lays the groundwork for a potential tool to identify at-risk patients and guide them toward safer care.
From research to real-life impact
The research team envisions an app for clinicians that uses a simple questionnaire to assess a patient’s risk of hospitalization. Questions might include current prescriptions, lifestyle factors (e.g. smoking and alcohol use) and chronic conditions like cancer or hypertension. The tool would then generate a risk score, allowing clinicians to make informed decisions in real time.
Such a tool could serve as a low-cost, high-impact intervention to keep patients safe and create savings for the NHS. By identifying high-risk patients early, clinicians may adjust medication regimens, encourage physical activity or address modifiable lifestyle factors—simple steps that could significantly reduce an individual’s risk of an emergency hospital admission.
While the app could be developed relatively quickly, integrating it into clinical workflows would require regulatory approval and trials. However, the potential benefits—fewer hospital admissions, improved patient safety, and reduced health care costs—make this a compelling investment, the researchers believe.
The team hopes such a tool would raise awareness among health care professionals, particularly those in primary care, community pharmacies and hospices, where early intervention could help prevent emergency hospital admissions.
Mr. Olender said, “As populations age worldwide, addressing inappropriate polypharmacy has become a key public health priority. Our new study contributes to the international evidence base by employing advanced data-driven methods to gain a deeper understanding of the scale and consequences of this issue in the UK context.
“Our aim is to turn the study’s findings into an impactful tool to support safer prescribing and improve the care of older adults.”
Dr. Nishtala said, “Inappropriate polypharmacy remains a global issue, and the identification of consistent risk factors across studies highlights the timeliness and relevance of the current investigation.
“A tool that helps assess the risk of hospitalization in older adults could bring real benefits. It might spare patients and their families the stress and disruption of a hospital stay, support healthier aging by keeping people out of environments where they’re more vulnerable to infections and complications, and ultimately help the NHS save valuable resources.”
More information:
Robert T Olender et al, Potentially inappropriate polypharmacy is an important predictor of 30-day emergency hospitalisation in older adults: a machine learning feature validation study, Age and Ageing (2025). DOI: 10.1093/ageing/afaf156
Citation:
Too many medicines, too many hospital visits: Study highlights hidden risk for older adults (2025, July 3)
retrieved 3 July 2025
from https://medicalxpress.com/news/2025-07-medicines-hospital-highlights-hidden-older.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.
Inappropriate polypharmacy—the excessive or unnecessary use of multiple medications—is a major driver of emergency hospital admissions among adults aged 65 and over, according to a new study from the University of Bath in the UK.
The researchers hope their findings will pave the way for the development of a digital tool—such as an app—to proactively identify older adults at risk of medication-related harm and intervene before a hospital visit becomes necessary.
The study—published in Age and Ageing—is the first of its kind to use data-driven methods to explore how potentially inappropriate polypharmacy contributes to short-term hospitalization in older adults.
With this population growing rapidly and facing increased risks of complications from being hospitalized, the findings reinforce concerns in geriatric care over the dangers of overprescribing.
The hidden dangers of overprescribing
Older adults often take multiple medications to manage chronic conditions such as diabetes, hypertension and arthritis. This can lead to prescribing cascades, where side effects from one drug are treated with additional medications, creating a cycle of escalating complexity and risk.
For instance, a patient might be prescribed a drug for pain management, develop high blood pressure as a side effect and then receive another medication to manage that new symptom. Over time, this can lead to a complex web of prescriptions, carrying the risk of harmful interactions.
Ph.D. researcher Robert Olender from the Department of Life Sciences at Bath, who led the study under the supervision of Dr. Prasad Nishtala and Dr. Sandipan Roy, said, “With more older adults on complex drug regimens, we need proactive ways to reduce preventable emergency hospitalizations.”
Though the new research is focused on data from the UK, polypharmacy among older adults is known to be a growing problem globally, with studies from countries that include the US, Australia, New Zealand and across Europe consistently linking polypharmacy to increased risks of hospitalization, adverse drug reactions and reduced quality of life.
In an earlier study based on a New Zealand dataset, also carried out by the team at Bath, a strong correlation was found in older people between a high drug burden, alcohol consumption and smoking with an increased risk of 30-day hospitalizations.
Using machine learning to predict hospitalization
The study used a large UK dataset to develop three machine learning models capable of predicting 30-day emergency hospitalization in older adults with around 75% accuracy.
A key variable in these models was the Drug Burden Index (DBI), which measures the cumulative effect of medications with sedative and anticholinergic properties. Anticholinergics are a class of drug used to treat various chronic conditions such as dementia, depression, urinary incontinence and chronic obstructive pulmonary disease (COPD).
The cumulative effects of these drugs consistently emerged as one of the strongest predictors of a person being at risk of emergency hospitalization. Other predictors included impaired mobility, a history of fractures and falls, smoking and excessive alcohol consumption.
What makes this study unique is its focus on a previously underexplored dataset and age group, offering new insights into a long-standing issue. While the dangers of polypharmacy are well known, this research highlights the link between polypharmacy and short-term hospitalization. It also lays the groundwork for a potential tool to identify at-risk patients and guide them toward safer care.
From research to real-life impact
The research team envisions an app for clinicians that uses a simple questionnaire to assess a patient’s risk of hospitalization. Questions might include current prescriptions, lifestyle factors (e.g. smoking and alcohol use) and chronic conditions like cancer or hypertension. The tool would then generate a risk score, allowing clinicians to make informed decisions in real time.
Such a tool could serve as a low-cost, high-impact intervention to keep patients safe and create savings for the NHS. By identifying high-risk patients early, clinicians may adjust medication regimens, encourage physical activity or address modifiable lifestyle factors—simple steps that could significantly reduce an individual’s risk of an emergency hospital admission.
While the app could be developed relatively quickly, integrating it into clinical workflows would require regulatory approval and trials. However, the potential benefits—fewer hospital admissions, improved patient safety, and reduced health care costs—make this a compelling investment, the researchers believe.
The team hopes such a tool would raise awareness among health care professionals, particularly those in primary care, community pharmacies and hospices, where early intervention could help prevent emergency hospital admissions.
Mr. Olender said, “As populations age worldwide, addressing inappropriate polypharmacy has become a key public health priority. Our new study contributes to the international evidence base by employing advanced data-driven methods to gain a deeper understanding of the scale and consequences of this issue in the UK context.
“Our aim is to turn the study’s findings into an impactful tool to support safer prescribing and improve the care of older adults.”
Dr. Nishtala said, “Inappropriate polypharmacy remains a global issue, and the identification of consistent risk factors across studies highlights the timeliness and relevance of the current investigation.
“A tool that helps assess the risk of hospitalization in older adults could bring real benefits. It might spare patients and their families the stress and disruption of a hospital stay, support healthier aging by keeping people out of environments where they’re more vulnerable to infections and complications, and ultimately help the NHS save valuable resources.”
More information:
Robert T Olender et al, Potentially inappropriate polypharmacy is an important predictor of 30-day emergency hospitalisation in older adults: a machine learning feature validation study, Age and Ageing (2025). DOI: 10.1093/ageing/afaf156
Citation:
Too many medicines, too many hospital visits: Study highlights hidden risk for older adults (2025, July 3)
retrieved 3 July 2025
from https://medicalxpress.com/news/2025-07-medicines-hospital-highlights-hidden-older.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.
