How to avoid polypharmacy
Older adults make up about 13% of the U.S. population today but take almost 30% of all medications prescribed. As the Baby Boomers age they will add 77 million people to this age group, meaning that nearly one in five people in the U.S. will be aged over 65. About 8 million of these will be 85 or older (the "oldest old") with a majority of this group being women.
Polypharmacy problems can occur for many reasons
Medication problems are not just caused by interactions between drugs, but by problems that can occur before the patient even takes a drug.
- Is your eyesight failing so you can't read the labels on your medicines?
- Do you have arthritis and can't open the bottles?
- Do you have a condition that makes it hard to swallow pills?
- Have you ever forgotten to take your medicine? (See our section called Remembering to take your medicines).
Most older adults are on some prescription medicines. Many also take over the counter preparations such as herbs or vitamins, often because a relative suggests them. Research shows overwhelmingly that people who use herbs, vitamins or other over-the-counter (OTC) products do so without talking to a physician or pharmacist first. For more information on OTC preparations look at our section called Herbs, Vitamins and other OTC products.
Other problems may be caused by the strategies that older people use to lower costs, perhaps only taking medications when they are in pain, or taking half the prescribed amount, or just not filling all of their prescriptions. Some older adults also drink alcohol or smoke regularly. Any or all of these factors could combine to cause problems.
Patients, physicians and pharmacists can work together to help prevent the problems that might occur if an older adult is taking several medications. Keep the following points in mind:
- Avoid combination products such as cold formulas. Ask your pharmacist to help you find a product just for your symptoms and not for every possible symptom.
- Make sure you (and your primary caregiver, if you have one)are aware of all other doctors or caregivers who prescribe medications.
- Bring your pill bottles to every appointment.
- Learn your medicines by name and what they are for.
- Ask your primary caregiver or your pharmacist to run your medication list through a drug
interactions database to identify possible problems.
- If you do find a possible problem, check with your doctor. Sometimes doctors prescribe medications that could be risky, but the patient's condition means that it is more risky not to take them.
- Carry your current medications list everywhere and take it to your doctor each time you have an appointment.
Be responsible for your own well-being
If you can't afford your medications talk to your doctor and pharmacist about ways to decrease costs.
It is your doctor's responsibility to insure that your medications are safe for you and that you take them safely, as prescribed. Be responsible, ask questions, talk to your doctors and pharmacists. Polypharmacy doesn't have to happen - just be on the lookout for signs and symptoms.
What is the U.S. Government doing about polypharmacy problems?
The Government is concerned about the risks polypharmacy and has published objectives in its Healthy People
2010 publication about the safety of medical products, including drugs (See Chapter 17: Medical Product Safety. These objectives include close monitoring of adverse medical events, linking information systems to prevent errors, having doctors and pharmacists regularly review the medications a patient is taking, and counseling the patient about prescriptions.
