The elderly are not making the most out of their medication, suggests a new study published Sunday in the British Journal of Clinical Pharmacology.

For the study, researchers observed the prescription habits of 503 seniors aged 80 and over who lived in Belgium for 18 months. While more than half (56 percent) fit the criteria for prescription misuse — for example, taking too much of a drug or taking drugs that may cause more harm than good — an even larger percentage (67 percent) weren’t taking enough of the right prescriptions for their underlying medical conditions. Overall, 58 percent had been prescribed five or more medications at once, and only 17 percent recieved the right blend of drugs.

"Taking too many medications or unsafe medications are known to cause adverse health outcomes; however, we have shown that not taking essential, beneficial medications is more frequent and can be more strongly associated with negative outcomes," said lead author Maarten Wauters of Belgium’s Ghent University in a statement. "Prescribing medications to older persons should be done after careful thought, balancing the benefits and risk of every medications at regular intervals."

While the health risks of misuse weren’t clear, the researchers did find that each instance of an underused medication was associated with a 39 percent increased risk of death, and a 26 percent increased risk of hospitalization.

The results obtained by Wauters and his colleagues line up well with other studies of prescription use among the elderly, including research performed in the United States. In 2006, a smaller study of 196 U.S. veterans over the age of 65, who took five or more medications, revealed that 65 percent were taking inappropriate or unneeded medications, while 64 percent weren’t taking enough of another medication. Other research has found that the elderly face greater health risks when taking many medications at once than the general public, either from the prescriptions themselves or when combined with recreational drugs like alcohol.

Although as the authors and others note, the fact that older adults are taking more prescriptions than ever before isn’t necessarily bad, given the rising trend in chronic health problems for the aging population. What is needed, they believe, is a smarter system of drug management, one that would allow patients, doctors, and even pharmacologists to coordinate and figure out the proper balance of medications in a timely and up-to-the-minute fashion.

"Clinical pharmacologists can help prescribers to clearly assess misuse and underuse of medications in full knowledge of the patient, their comorbidities, and their medications,” Wauters said. “They can help to build electronic systems for constant monitoring of the quality of prescribing, using evidence-based criteria of potentially inappropriate prescribing."

Source: Wauters M, Elseviers M, Vaes B, et al. Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalisation in a cohort of community-dwelling oldest old. British Journal of Clinical Pharmacology. 2016.