Understanding Polypharmacy and Its Risk to Seniors
A considerable majority of people over the age of 65 take prescription medication. In fact, a large swath of these seniors is on multiple medications. As will be discussed further in a moment, some chronic conditions necessitate that a senior be on multiple medications. In addition, there are a significant number of instances in which a medication needs to be added to a senior’s regimen to counteract side effects from another prescription. A situation in which a person takes multiple medications is technically known as polypharmacy.
In this article, we provide you with information on several matters associated with polypharmacy:
- Definition of polypharmacy
- Understanding the relationship between seniors and medications
- Signs and symptoms of too many medications
- Steps to reduce polypharmacy
- Need for a comprehensive list of medications and supplements
- Need to read medication instructions and inserts
- Consolidate prescriptions in one pharmacy
- Hold regular medication reviews
Definition of Polypharmacy
As noted generally a moment ago, polypharmacy is the simultaneous use of multiple medications. While this may not seem like a bad thing, being on too many medications can lead to potentially dangerous drug interactions. It can also expose an individual to many different side effects simultaneously. Polypharmacy applies not just to prescription meds but to over-the-counter or OTC medications as well. Moreover, dietary supplements are included in what counts towards a situation involving polypharmacy.
Seniors and Medications
Treating only one chronic medical condition may require several prescriptions, but for seniors who often have several ailments, their medication regimens can be very complex. It can get to the point where the patient does not know all the drugs they are taking, why they are needed, or how to take them properly. Medication errors are more likely with complex regimens and can also be dangerous. Worse, physicians may not be aware of all the medications their patients are taking.
Research shows that the average older adult takes four or more prescription drugs on a daily basis. Thirty-nine percent of people 65 years of age or older take five or more prescriptions each and every day. Each medication is designed to treat or manage a specific medical problem, and each drug also has its associated risks and side effects. The more medications a person takes, the higher the chances of experiencing adverse reactions, negative side effects, and even life-threatening conditions. Generally speaking, polypharmacy among the elderly is a significant contributor to disability, frailty, falls, long-term care placement, and a decreased quality of life.
Signs and Symptoms of Too Many Medications
“Polypharmacy is a huge problem in our society,” explains Stephen Sinatra, MD, FACC, FACN, CNS, CBT. Dr. Sinatra is an internationally renowned cardiologist. He is the author of The Great Cholesterol Myth. According to Dr. Sinatra, older patients are often put on five or more medications at once. Because of this relatively common practice, it is no wonder that many older women and men develop serious side effects from their medications. According to Dr. Sinatra, this situation is particularly common among those who have been diagnosed with heart disease, recently suffered a heart attack, or recently suffered a stroke.
The more commonly occurring signs and symptoms of a senior who is on too many medications include:
- Tiredness
- Sleepiness
- Decreased alertness
- Constipation
- Diarrhea
- Incontinence
- Loss of appetite
- Continuous confusion
- Episodic confusion
- Falls
- Mobility issues
- Depression
- General lack of interest
- Weakness
- Tremors
- Hallucinations
- Anxiety or excitability
- Dizziness
- Changes in sexual behavior
- Skin rashes
Steps to Reduce Polypharmacy
Responsible medication management is the best way to prevent adverse health outcomes related to medication use in the first instance. A senior and their entire care team must work together toward this goal. Achieving this objective may require that a senior have a caregiver that assists in medication management issues.
A critical step to take regarding getting a senior’s polypharmacy under control is to create a master list of all medications (prescription and over-the-counter) and any supplements being taken. Odds are, a senior’s medications are prescribed or recommended by more than one physician if he or she has different medical conditions being treated with meds. By taking this step, all healthcare providers – a senior’s entire care team – will theoretically be on the same page regarding medications.
Need for a Comprehensive List of Medications and Supplements
The first and most crucial step is to inform every physician involved in your loved one’s treatment of every medication and supplement your loved one takes. The easiest way to compile this vital, comprehensive list is to collect every pill bottle or container containing meds or supplements. From these bottles, a complete list can be created that includes the following:
- Drug name
- Strength (in milligrams or international units)
- Recommended dosage
- Instructions (including frequency and timing)
- Any cautions stated on the bottle or package
Need to Read Medication Instructions and Inserts
When working on getting polypharmacy under control, it is wise for a senior, family member, caregiver, or other trusted individual to thoroughly review medication instructions and inserts. By undertaking this course of due diligence and self-education, a senior and caregiver or another family member will have a much clearer picture of the mechanics of all medications and supplements being taken.
Consolidate Prescriptions at One Pharmacy
Polypharmacy can be better controlled and coordinated if all medications are obtained at the same pharmacy. As a consequence, existing medications should be consolidated at one pharmacy, and new prescriptions should be obtained from that same pharmacy.
Hold Regular Medication Reviews
After an initial review of a senior’s medications has occurred, future medication reviews should occur regularly. The timing and scheduling of these future medication reviews depend on the nature of the meds being taken by a particular senior. With that said, medication reviews should occur at least quarterly or every six months unless some event intervenes earlier. These regular reviews must become integral to a comprehensive and effective medication management process.