Approximately 1 in 5 adults between the ages of 40 and 79 take five or more prescription drugs. According to the data From the Centers for Disease Control and Prevention. And the older a patient is, the more drugs they are likely to take.
But taking too many drugs at the same time, known among medical professionals as “polypharmacy,” increases the risk of serious side effects and drug interactions, says the New York University Grossman School of Medicine and Geriatrics. Associate Professor Dr. Nina Blackman said.
Studies have shown that taking multiple medications can cause symptoms to develop faster. memory loss Some patients with mild cognitive impairment are at higher risk of: drop down Among people with balance problems or weak muscles. Also, certain drug combinations can cause excessive bleeding, dangerous hypoglycemia, or other serious complications that can kill hundreds of older adults. hospitalization every day.
Medicines are so important to improving our quality of life, but how do people end up taking so many medications unnecessarily and when to ask for help organizing their prescription list? It is important to understand.
How prescriptions stack up
As people get older, they become more susceptible to health problems such as diabetes, heart disease, arthritis and high blood pressure, “which ultimately leads to them taking more and more medications,” Dr. Blackman said. Many people never stop taking the drugs they have been prescribed for years, even if they no longer need the drugs or even if new formulations become available that can treat different symptoms at the same time.
Patients may see different health care providers, and each health care provider may prescribe medications without necessarily communicating with each other.
Your health care professional may prescribe a drug to treat the side effects of another drug. Doctors call this the “prescription cascade.” For example, people who take certain over-the-counter pain medications called nonsteroidal anti-inflammatory drugs may experience an increase in blood pressure, which doctors may misdiagnose as a new disease and may prescribe calcium channel blockers as treatment. may be prescribed. However, in some people, these antihypertensive drugs can cause ankle swelling, and as a result, diuretics may be prescribed to reduce fluid buildup in the body.
“So you’re chasing side effects from one drug after another,” Dr. Blackman says.
Barbara Farrell, a scientist at the Bruyère Institute in Ottawa, said older patients may be less careful with medications because their kidney and liver function declines with age, which can reduce their ability to filter some drugs. However, he said that there may be a high possibility of developing new or more severe side effects. . This may result in patients being prescribed more medications to treat side effects.
Polypharmacy is most common in older people, young people, and even children, but especially those with complex chronic conditions such as epilepsy, learning disabilities, and mental health problems, who find themselves taking too many medications. It may happen.
Further complicating the problem, Farrell said, pharmacists and doctors don’t always know when and how to help patients safely come off their medications. But in recent years, she and other experts have pushed for further guidelines on reducing or stopping prescription drugs.
How to review the medications you are taking and reduce them as much as possible
Kuldip Patel, senior deputy chief pharmacy officer at Duke University Hospital in North Carolina, said that ideally, doctors and pharmacists should perform so-called medication adjustments at every office visit. To do this, his team reviews the list of medications people are taking each time they are admitted or discharged. But that doesn’t always happen in all medical settings, he said.
Experts suggest asking your doctor or pharmacist to perform a complete medication review at least once a year.Many pharmacies offer such evaluations for free. drug therapy management program. Make a list of your medications, including supplements and over-the-counter medications, or remove all bottles of medication and bring them with you to your appointment, says Dr. Patel.
But the best time to talk about prescription drug use is probably before starting a new drug. Ask your doctor questions such as, “Are you experiencing any symptoms that may be side effects of the medications I’m taking?” or “Can I manage this condition by first changing my lifestyle?”
Dr. Farrell said if you need the medication, see if you can start with a lower dose. Remind your doctor about the medicines you are taking and ask how new medicines may interact with them.
Finally, ask your doctor how long you need to take the medication and discuss a plan to stop taking it if necessary. You need to understand how your health care provider intends to help you taper off your medication, what withdrawal symptoms to watch for, and how to prevent the problems you were being treated for from coming back.
“These are questions you should ask when you start taking these medications, even if you’re a teenager or in your 20s,” Dr. Farrell said. “And I hope that one day people can collectively prevent him from getting into a situation where he’s on 25 different medications.”
