• Aging Gracefully: Reducing the Risks of Polypharmacy

    Image for polypharmacy article It is no secret that we are living longer. Unfortunately, we are not necessarily living healthier. An ever-growing percentage of the population is managing one or more medical conditions, which are managed by one or more medicines.
    While such medicines can help maintain health and prevent further illness, taking combinations of drugs means that you could be at risk for drug interactions. Polypharmacy presents growing risks among the elderly in the US.

    What Is Polypharmacy?

    Polypharmacy is defined as the concurrent use of many different medicines by the same person. This can result in a gradual accumulation of side effects. Problems may be increased by taking:
    • Dosages that are too high
    • Medicines that are incorrectly prescribed or filled
    • Medicines that interact with or duplicate the actions of other medicines
    • Herbal supplements that interact with prescription medicines
    Polypharmacy can result in adverse drug events, complicating therapy, increasing cost, and presenting a challenge for healthcare agencies. Unfortunately, the symptoms caused by polypharmacy can be confused with the normal aging process, such as:
    • Tiredness, sleepiness, or decreased alertness
    • Constipation, diarrhea, or incontinence
    • Loss of appetite
    • Confusion
    • Falls
    • Depression or lack of interest in your usual activities
    • Weakness
    • Tremors
    • Visual or auditory hallucinations
    • Anxiety or excitability
    • Dizziness
    • Decreased sexual behavior

    Are You at Risk for Harm by Polypharmacy?

    The elderly may be at the highest risk for polypharmacy because they are most likely to be taking multiple medicines. It is also true that any patient with multiple medical conditions or being treated by multiple doctors may be at risk.
    To assess your risk for harm from polypharmacy, answer these 10 questions. If you answer yes to any of the following, you should see your doctor or your pharmacist and ask for a complete medicine review:
    • Do you take five or more prescription medicines?
    • Do you take herbs, vitamins, other dietary supplements, or over-the-counter medicines?
    • Do you get your prescription filled at more than one pharmacy?
    • Is more than one doctor prescribing your medicines?
    • Do you take your medicines more than once a day?
    • Do you have trouble opening your medicine bottles?
    • Do you have poor eyesight or hearing?
    • Do you live alone?
    • Do you have a hard time remembering to take your medicines?

    Top 10 Tips for Reducing the Risks of Polypharmacy

    The good news is there are things you can do to help reduce your risk of polypharmacy. Here are some tips to help you:
    • Make a list of every medicine you are taking, including herbs and supplements, vitamins, and over-the-counter drugs. Update it after every doctor’s visit.
    • Carry your medicine list with you everywhere. Bring it and your pill bottles along when you see the doctor.
    • Ask your doctor or pharmacist to check your list for possible interactions.
    • If you have more that one doctor, make sure each one knows what the other is prescribing.
    • Ask your primary doctor if you need to take all the medicines on the list, or if you can reduce the dosages.
    • Always read labels. They may help you avoid a possible drug interaction.
    • Always get your prescriptions filled at the same pharmacy.
    • Learn the names of your medicines and why you take them.
    • Avoid combination products like cold remedies. Ask for help buying only the specific medicine that treats the symptoms you are experiencing.
    • Never take a new drug without discussing side effects and interactions with your doctor, your pharmacist, or both.
    Remember, if you feel that you are taking too many drugs or if you are confused about the number or quantity you are taking, talk to your doctor. Polypharmacy does not need to happen. There are many ways that you and your doctors can work together to reduce or avoid the risks of taking multiple medicines.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org/

    Health Alliance Plan http://www.hap.org/

    CANADIAN RESOURCES

    College of Pharmacists of British Columbia http://www.bcpharmacists.org/

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

    References

    Are you at risk for polypharmacy? Health Alliance Plan. Available at: http://www.hap.org/info/formulary/polypharmacy%5Frisk.php . Accessed on September 24, 2003.

    How to avoid polypharmacy. University of North Carolina School of Medicine. Available at: http://www.med.unc.edu/aging/polypharmacy.avoid.htm . Accessed on September 24, 2003.

    Patel RB. Polypharmacy and the elderly [abstract]. J Infus Nurs. 2003;26(3):166-169.

    Symptoms of polypharmacy. University of North Carolina School of Medicine. Available at: http://www.med.unc.edu/aging/polypharmacy/symptoms.htm . Accessed on September 24, 2003.

    What is polypharmacy? Health Alliance Plan. Available at: http://www.hap.org/info/formulary/polypharmacy.php . Accessed on September 24, 2003.

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