November 28, 2023 | Prevention of Illness and Management of Chronic Conditions
Adults aged 65 or older take more medications than any other age group. The Centers for Disease Prevention and Control estimates that 83% of U.S. adults in their 60s and 70s had used at least one prescription drug in the previous 30 days, and about one-third used five or more prescription drugs. This is considered polypharmacy, or the use of five or more prescription drugs at the same time. Polypharmacy, in large part, is unavoidable. Many older adults have chronic health conditions that they need to use multiple drugs to manage appropriately. However, inappropriate polypharmacy, the use of excessive or unnecessary medications, can and should be avoided.
Inappropriate prescribing increases the risk of adverse drug effects, putting the older adult at increased risk for falls and cognitive impairment, harmful drug interactions, and drug-disease interactions. Some medications may be causing side effects, which are then treated by another drug, causing a prescription cascade. In certain circumstances, the drug prescribed no longer fits the patient’s desired goals but remains on the treatment due to lack of communication.
Arrange an appointment with your provider as soon as possible if you:
- Do not know the names and dosages of the medications you are taking and what they are for.
- Feel your health status has changed and would like to adjust the goals of your treatment.
- Would like to reduce/change the amount of medication you are currently taking.
- Are having unwanted side effect/s of medication.
- Are unable to manage the cost or amount of medications.
- Are not taking a medication according to the instructions.
In many cases, an honest and transparent conversation with your provider will help open the doors of communication. To further avoid inappropriate polypharmacy, remember the following tips:
- Keep an updated list of medications, dosage, and how and when you take them, including supplements. Bring this to all appointments and keep it updated.
- At each visit, ask your doctor if the medications they are prescribing are still recommended or if they can be reduced/removed.
- Be aware of any side effects you may be experiencing. Check with your doctor right away if you feel a change in your memory, have had a recent fall, or any other altering side effects since starting a medication.
- Make sure your doctor understands/knows your goals for your health.
- Check with your doctor before taking any over-the-counter medications or supplements.
- Use a pill box organizer to check yourself for compliance.
Managing multiple chronic medical conditions can be complex. Factors such as numerous providers, lack of communication between those providers, cost of medications, drug interactions, medication non-adherence, and changes in the way drugs are processed in the aging body all contribute to increased risk of adverse outcomes.
In our complicated medical system, it is up to the patient and their advocates to avoid inappropriate polypharmacy. If you have a concern, always address it with your provider immediately. If you are curious about a medication contributing to adverse outcomes, go to GeriatricsCareOnline.org for reputable information to discuss with your physician.