Managing your Medicine: Seniors and Polypharmacy
Although seniors make up for less than 13% of the US population, they use nearly 33% of overall prescription medications annually. American Nurse Today states that “44% of men and 54% older than age 65 take five or more medications per week”. These statistics paired with how we age and how our bodies metabolize the medications we take puts older adults at a risk of adverse drug effects known loosely as polypharmacy. Senior Living Link had the opportunity to speak with Carolyn Hey, a licensed pharmacist about her views on polypharmacy as well as a few ways to help reduce polypharmacy among the senior population. Hey, graduated from Campbell University College of Pharmacy and Health Sciences and currently practices at a drug store in a mid-size community that has nearly a 12% overall population of persons over the age of 65.
SLL: As the term “polypharmacy” is a loose term without a consensus of a true definition, how do you define it or how is the vernacular used most referring to the senior population?
Carolyn Hey PharmD, MSCR: Polypharmacy is a hard term to clearly define; however, within the scope of the elderly it is a senior patient taking several (again term is not clearly defined 4+,5+,7+…) medications; prescription and possibly over-the-counter (OTC) medications that may also include herbals and supplements. Some patients obtain these medications from numerous pharmacies, making it difficult as a pharmacist to counsel and instruct a patient thoroughly on all medications that the patient is consuming. It is not uncommon for our senior patients to not know (“I can’t remember…”) what they are taking from all the various pharmacies or do not disclose OTC medications because they do not deem them an issue when taking prescription medications. Polypharmacy and using multiple pharmacies is a challenge we face daily with our senior patients.
SLL: What is some advice for seniors that take numerous prescription and non-prescription medications daily?
Carolyn Hey PharmD, MSCR: I try to encourage my senior patients to fill all their medications at one pharmacy and keep a list of all medications they are taking prescription or non-prescription with them at all times. I feel it is important for seniors to periodically have a pharmacist conduct a comprehensive medication therapy management/review to help reduce polypharmacy and improve medication therapy.
SLL: How can family members help seniors with their medication?
Carolyn Hey PharmD, MSCR: Family members can play a big role in helping seniors keep track of their medications and safely be compliant with therapy. Polypharmacy can begin the senior patient down the vortex of treating a condition with a medication, having a side effect, adding another medication onto the regime to treat the side effect, then another and another and so on.
SLL: If you have a bad side effect to a medicine that you begin taking, is it okay to stop taking it right away?
Carolyn Hey PharmD, MSCR: If a patient has a bad side effect to a medication, he or she should call their physician or pharmacist immediately to determine what should be done next. Some medications can be stopped right away, some may need to be tapered off from or sometimes a medication needs to be switched to an alternative drug.
SLL: As a pharmacist, how are you able to help prevent unnecessary adverse drug effects from the combination of so many medicines for seniors?
Carolyn Hey PharmD, MSCR: To help protect our seniors from adverse drug events because of polypharmacy, it is vital that ALL healthcare providers take a “team” approach to treating our senior patients. Open lines of communication are essential between providers and pharmacists. I call providers all the time regarding medication use, directions, clarifications, interchanges, dosing concerns, drug-disease issue, deprescribing, allergies and more. Patient safety is paramount in any clinical setting. Like I always tell my technicians: when in doubt ask, never guess or assume!
Do you feel comfortable with your medication management plan? If not, reach out to family, your doctor, and your pharmacists about the medicine you are taking to make sure the medicines you are taking are necessary and to help prevent adverse drug effects.
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