The Problem with the Pills You’re Taking
Some Americans take 14 to 18 different medications in a year's time
When a New Year’s resolution focuses on making life happier and healthier and can be accomplished in a few hours with the help of others — what’s not to resolve?
It’s time to talk with your pharmacist and get a “polypharmacy” checkup, if you fit the profile.
Polypharmacy is the use of multiple medications at the same time ("five" is the typical benchmark), whether for one or more conditions. I suggest the same resolution on behalf of any seniors in your life, because people between the ages of 65 and 84 use an average of 14 to 18 different prescriptions in a year's time. (Yes, you read that right.)
Anyone who takes five or more drugs — including over-the-counter meds, vitamins, and herbal supplements — should understand the risk of not checking in annually. Frailty, falls, dementia-like symptoms, depression, and loss of independence are all consequences of taking too many medications, the wrong medications, or the wrong combination of medications.
The related issues of noncompliance, side effects, adverse drug interactions, and unnecessary prescribing are also estimated to be in the top five unreported causes of death in those age 65 and older.
And up to 7 percent of all hospital admissions are due to adverse drug reactions. The practical costs of medication-related health care are estimated at $200 billion per year.
A 'Brown Bag Checkup'
Let your pharmacist know you want to do a "brown bag checkup" — it's called that because that's an easy way to tote all those bottles. (Under Medicare Part D, there is a Medication Therapy Management benefit; check with the Part D insurer for qualifying criteria.)
- Keep a current list of medications and dosages.
- Give your health care proxy a copy.
- Use only one pharmacy to fill all prescriptions.
- Read and understand label instructions.
- Be aware of possible side effects and interactions before taking anything new, prescribed or over-the-counter.
- Use a chart or pill dispenser for compliance.
- Make sure meds are properly stored.
Make notes, share how and when each medication is taken, and aim for complete honesty. How are drugs stored? Is there a reliable system to encourage compliance? Are dosages ever intentionally skipped? If so, why? Are some symptoms never relieved?
The pharmacist and/or physician will look for: drug-drug and drug-disease interactions; duplications; drugs used to address side effects of other drugs; prescriptions matched with current diagnoses; non-medication alternatives; and proper use by the patient.
What's left of that process should only be the drugs that work well together for the good of the patient.
With over 4 billion prescriptions filled each year, is it any wonder polypharmacy is an issue in America? It doesn't have to be for you and your loved ones. Make and keep this resolution.
Attorney Jo Kline Cebuhar is the author of books on medical decision-making and the meaning of legacy, including "The Practical Guide to Health Care Advance Directives."