In these pandemic times, I am sure many people who live with health concerns have had conversations with their doctor about the drugs they are taking to manage the day to day. It’s important to have another conversation - “Am I taking too many medications?; how many of the drugs I take interact with each other and I may not even know it?”
Polypharmacy occurs when a patient takes too many medications. It is most common among seniors and individuals with multiple medical conditions. Since older people metabolize drugs differently, the combined effects of numerous medications can be especially harmful. It’s 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 and exposure to many different side effects all at once. The same is true for over-the-counter (OTC) medications and various supplements, which patients often use as needed without informing doctors.
It is vital to have an honest conversation with your doctor. Without that, they cannot give fully informed advice; that does no one any good and it’s actually an insult to a professional’s credibility. Think about that.
Treating only one chronic medical condition may require several prescriptions, but for seniors who often have several ailments, medication regimens can be complex, getting 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 be dangerous as well. What is worse is that physicians may not be aware of all the medications their patients are taking.
‘Brown bag’ appointments is a way to clean out the cabinet as it were. If an elderly person lives with an adult child or other provider of help, include that individual in all discussions. Armed with a list of all drugs taken and names of prescribing physicians allows for a dialogue about why, for example, a pain management drug prescribed for a fixed number of days for an issue that’s been resolved for years, is still being used. How many other drugs are used for conditions that no longer exist?
The average older adult is thought to take four or more prescription drugs each day, but a whopping 39 percent of seniors take five or more prescriptions each day. While each one was created to treat or manage a specific medical problem, each also comes with its own risks and side effects. The more medications a person takes, the higher the chances are for experiencing adverse reactions, negative side effects and even life-threatening conditions. Overall, polypharmacy in the elderly is a major contributor to disability, frailty, falls, long-term care placement and a decreased quality of life.
I’m still having difficulty wrapping my brain around the reality that I am a senior. Wow! When did that happen? Living on my own and only taking one script medication for a thyroid disorder, I am fortunate that I never got into a cycle of taking drugs just because a doctor or specialist said I must because they’re glued to that bulky blue book aka The Compendium of Pharmaceuticals and Specialties. While in university, when I was prescribed a combo of drugs to manage CP, I browsed through Dad’s CPS to learn about the medications I was taking. Up that point, I took no CP-management protocols. I was concerned about one, Dantrium, a muscle relaxant. Over time it can cause liver issues. I took the trio of meds for a few more years and then stopped, using only one, Tylenol #3 ‘as required’ rather than ‘as directed’. I typically take that when my spine hurts but I don’t take it during the day, always at night at bedtime, so I’ll be safe in my bed and not roaming around loose risking a fall down and go boom episode. Been there, done that!
Key to successful management is to have an effective ‘hall monitor’; someone to police the flow of drugs and who is knowledgeable about interactions and will confer with physicians if there is a concern about a patient’s use or mis-use. Sticking with one pharmacy reduces the paper trail and minimizes the potential for patient self-harm.
So far, I’m able to self-care. Let’s hope it continues for some time to come.
Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with Miss Lexie, a rambunctious Maltese and Mr. Malcolm, the boisterous Havanese. She can be reached via email at Carla MacInnis Rockwell
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