Polypharmacy & Safe Use of Medications

Polypharmacy means "many drugs" and refers to problems that can occur when a patient is taking more medications than are actually needed. Polypharmacy is a particular concern for older adults, who account for almost 30% of all prescribed drugs.

The typical older adult takes one or more prescription drugs plus several over-the-counter (OTC) remedies, such as antacids, laxatives, or pain-killers, often used without informing their physician. Some patients have no problems at all, but others suffer because of the combination of drugs they take.

In some cases, older adults may also be taking prescriptions from multiple doctors who are unaware the patient is receiving prescriptions from other doctors. There can be serious complications from drug interactions.

Symptoms of Polypharmacy

Polypharmacy is sometimes overlooked because the symptoms it causes can be confused with symptoms of normal aging or another disease. Signs that are caused by interactions between drugs or side-effects of drugs can include the following:

• Tiredness, sleepiness, or decreased alertness
• Constipation, diarrhea, or incontinence
• Loss of appetite
• Confusion (all the time or only sometimes)
• Falls
• Depression or lack of interest in usual activities
• Weakness
• Tremor
• Visual or auditory hallucinations
• Anxiety or excitability
• Feeling dizzy
• Decreased sexual behavior
• Skin rashes

Sometimes side effects occur shortly after starting a new medication, but in other cases they may take a while to appear.

Medication Problems Can Occur for Many Reasons

Medication problems are not just caused by interactions between drugs, but can also be caused by problems that can occur before the patient even takes a drug. Factors that contribute include the following:

• Failing eyesight whereby the patient can't read the labels on medicines
• Arthritis that prevents the care recipient from opening the bottles
• Difficulty swallowing
• Forgetfulness
• Attempting to lower personal expenses, such as only taking medications when in pain
• Smoking
• Drinking alcohol

Using Medications Safely

Patients, physicians, pharmacists, and caregivers can work together to help prevent the problems that might occur if an older adult is taking several medications. Keep the following points in mind:

• Make sure you are aware of all other doctors who prescribe medications; This can’t be stressed enough
• Keep a daily record of all the drugs that are taken, including prescription and Over the Counter drugs; note the name of each drug, the doctor who prescribed it, the amount taken, and the times of day that it is taken 
• Take the current medication list to the doctors at every visit
• Always ask the doctor about the right way to take any medicine before using it
• Tell the doctor about past problems your care recipient has had with medicines, such as rashes, indigestion, dizziness, or not feeling hungry
• Call the doctor right away if there are any problems with medicines
• Be responsible, ask questions, talk to the doctors and pharmacists
• If medications can’t be afforded, talk to the doctor and pharmacist about ways to decrease costs
• Ask the pharmacist to run the medication list through a drug interactions database; if the pharmacist finds a problem, check with the doctor before discontinuing a drug or not starting a new one that the doctor prescribed
• If your care recipient has trouble with arthritis or another condition, ask the pharmacist for easy-to-open containers for medications
• If the label is hard to read, ask your pharmacist to use large type; make sure you can read and understand the drug name and the directions on the container; take medicine in the exact amount and on the same schedule prescribed by the doctor
• Check the expiration dates on medicine bottles, and throw the medicine away if it has passed this date
• Avoid combination products such as cold formulas; ask the pharmacist to help you find a product for the specific symptoms and not for every possible symptom

Remember:  

• DO NOT stop taking a prescription drug unless the doctor says it is okay—even if you are feeling better
• DO NOT take more or less than the prescribed amount of any drug
• DO NOT mix alcohol and medicine unless the doctor says it's okay
• DO NOT take drugs prescribed for another person or give drugs to someone else

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