A new report has confirmed what many people already know – older adults are taking way too much medication. A study published in April 2016 in JAMA Internal Medicine exposed the fact that 38.5% of adults with an average age of 71 take at least five prescription medications. A total of 67.1% take five or more drugs or supplements of any kind, including over-the-counter medicines. No wonder so many people have a tough time keeping track of their prescriptions. It’s common for patients to not be able to name their medications or the appropriate dosage when questioned. Many times, people can’t explain why they are on the drugs that they take every day. The scary part is that the risk of an adverse event increases by 7-10% with each medication.
Rather than trying to determine whether a symptom is a side effect from a prescribed medication, it’s not uncommon for physicians to prescribe another medicine to treat the symptom. Over-prescription is even more likely to occur if a patient sees many different physicians. Physicians are often hesitant to discontinue a medication prescribed by another doctor, and many doctors never follow up once a patient has been put on a medication to see if they still need the drug. Life circumstances can change the dosage required, or even eliminate the need for a medication – this can occur with weight changes, changes in the level of physical activity, and normal aging.
Between 2006 and 2014, the rate of older adults going to an emergency room because of adverse drug events doubled. Sixty percent of these visits were because of blood thinners, diabetes medications, and opioids. The other four types of drugs that increase the potential for adverse events include sedative-hypnotics, blood pressure medications, antipsychotics, and commonly used over-the-counter medicines such as antihistamines. In August 2017, Consumer Reports published the results of their nationwide survey showing that the number of prescriptions increased 85% in 20 years, while the population only grew by 21%.
The Beers criteria list drugs to avoid in the treatment of older adults, and they have been updated every three years, beginning in 2011. The 2019 measures include 30 medications or medication classes to be avoided in all older adults and 40 drugs or medication classes that should be used with caution or avoided in certain patients. A previous study cited by the Beers Criteria found that half of older adults use at least one potentially inappropriate medication; nonsteroidal anti-inflammatory drugs were the most common class of questionable prescriptions.
Community pharmacists also play a crucial role in the fight against polypharmacy. They have a perfect opportunity to start a conversation about why an individual is taking a specific medication and whether they know about the side effects or complications associated with their prescribed medications.
Polypharmacy is one more reason why every person should see a primary care provider (PCP), also referred to as a general practitioner (GP), regularly. This person acts as the “gatekeeper” for all of your care and is tasked with coordinating and evaluating all testing and medications prescribed for you by specialists.
This list of questions that you should ask your doctor or pharmacist about will help you to avoid becoming another statistic for polypharmacy.