Risks of polypharmacy

Created date

May 14th, 2019
Erickson Living Chief Medical Officer Matt Narratt, M.D., met with people moving to Windsor Run.

Dr. Narrett leads the medical team at all Erickson Living communities. A graduate of Harvard Medical School, he has been providing care for seniors for over three decades.

Today, medication is the cornerstone of health care treatment for many conditions, and in some instances, it seems miraculous that we can effectively treat or cure diseases once thought of as terminal. While these advances have revolutionized health care and helped millions, it is important to pause and reflect on the downside of too much medicine, particularly among seniors.

Almost half of adults 65 and older take four or more prescription drugs every day. This is commonly referred to as polypharmacy and can potentially be dangerous because, with each additional medication prescribed, the risk of experiencing an adverse drug event (ADE) rises. Seniors are particularly vulnerable because of metabolic changes with age, which often slow drug clearance from the body. Other contributing risks include visual impairment and cognitive difficulties, both of which making it challenging just to take a long list of medicines accurately.

The Centers for Disease Control and Prevention reports that people over age 65 visit emergency rooms 450,000 times a year due to adverse drug events. There are six classes of drugs that are implicated in most of these events: anticoagulants, antiplatelet dugs, diabetes medicines, opioid analgesics, antibiotics, and cancer drugs. In addition to prescription medications, ADEs can occur due to seemingly innocuous over-the-counter preparations. For instance, taking a pain reliever such as aspirin or ibuprofen can cause internal bleeding, and a common antihistamine called diphenhydramine (Benadryl) has been shown to be particularly dangerous for seniors.

What you can do

With the rise in adverse drug events and the recent challenges with the overuse of pain medication, the medical community has become increasingly aware of the risks associated with polypharmacy. If you want to minimize the number of medicines you take and make sure you absolutely need all the medicines you are on, please make an appointment to specifically address this issue with your primary doctor. Take the time before the visit to prepare a complete list of your current medications, or better yet, take all your current medicine bottles in to your doctor. Remember to include your over-the-counter medicines, herbal preparations, and dietary supplements.

Studies show that 90% of patients are willing to stop a drug if their doctor says there is a safe alternative. At your visit, you and your doctor will review each medicine with regard to risks, benefits, your expectations, and any alternatives to taking the medicine. The conversation should include questions such as: Do the risks of the medicines outweigh the benefits? Is the initial reason for prescribing the medicine still relevant? Are there any potential interactions among the medicines in your regime that should be considered? Once you settle on your regime for moving forward, you should keep the list with you in case of an emergency hospitalization and bring that list to every health care appointment so that different specialists won’t inadvertently prescribe a medication or treatment that may cause a reaction. A helpful resource is provided by the American Geriatrics Society (https://bit.ly/2DvglaI).

Please remember medication can improve the quality of your health and well-being, but each medicine has potential side effects. By taking an active role in managing your regime, you will maximize the benefit and limit the risk.

In good health,

Dr. Narrett