Polypharmacy

Polypharmacy

Managing multiple prescription medications, often called polypharmacy, is one of the most troublesome challenges for seniors dealing with several chronic illnesses simultaneously. As an example, a senior who has a heart condition, diabetes, and chronic lung disease-a common trio of illnesses-often must take numerous medications several times a day. Seniors take, on average, 4.5 drugs at any one time and have three times more adverse drug reactions than younger adults. Nursing home residents receive three to eight medications daily. Evidence points to the number of drugs taken as the leading factor in the high incidence of adverse drug reactions (Long, 1997). Recent efforts have been directed toward reducing medications to the minimum number and lowest dosage needed to control a disease process.

According to James Long, author of The essential guide to chronic illness, the picture of adverse drug reactions is complicated:

  • A Seniors response to a particular medication may change as the aging process continues. As such, the dosage and schedule for taking the medication may need to be changed.
  • Taking multiple medications increases the chance that a particular medication may react unfavorably with another medication or with a food that the senior eats regularly. If a senior is being treated by several different physicians-specialists, for example-it is possible that each is unaware of what is prescribed by the others. In addition, physicians may be unaware of the herbal or natural supplements, vitamins, and other over-the-counter remedies a senior may be taking, Seniors must maintain a complete list of all medications they take, including non-prescription and natural substances. Periodically (especially when seeking treatment for a new condition), they must ensure the list is reviewed before adding a new medication. You should encourage them to share this information with their physicians to avoid medications that counteract each other.

If a seniors eyesight or memory change, errors in dosage and scheduling of medications can occur. Visual limitations make it difficult, for example, to detect the difference in 5.0, 0.5 and .05 on a prescription label or to read the small printed instructions that come with a prescription. Seniors may forget they took their morning pills and take them again or, conversely, miss a dose, thinking that pills were taken earlier. Whenever unusual symptoms occur, it is wise to review how the patients medications are being taken. It may be necessary to create a large, printed schedule and put pills into a container that has separate sections for morning, afternoon, evening, and bedtime of each day. Throw away old prescriptions to reduce the chances of overdose or taking the wrong pill.

The above information was provided by the Society of Certified Senior Advisors (SCSA)