In the June 3rd issue of Advanced Natural Wellness you learned about four types of medications that are dangerous for aging adults. The list included non-steroidal anti-inflammatory drugs (NSAIDs), anticholinergic medications, acid reducers and muscle relaxers.
But there is a much larger problem when it comes to medicating older patients.
It’s something called polypharmacy, which basically means “the regular use of five or more medications at the same time.”
As older adults develop more and more chronic health conditions, the practice of polypharmacy becomes much more common. This creates a huge risk of negative health outcomes; falls, frailty, hospitalizations, disability and even early death.
In fact, research shows that patients taking five to nine medications have a 50% chance of an adverse drug interaction. Those chances go up to a full 100% when taking 20 or more medications.
And believe me! I have had patients come into my clinic who are taking five, 10, 15, 20 or more different meds.
How does this even happen?
What Leads to Overprescribing?
One thing people don’t always realize is that, even though medical records are computerized these days, medication data is not always complete, accurate and fully updated…and critically, not shared with other networks.
Dosages and frequencies may be out of date. There might be meds on the list that you are no longer taking. There could be ones you recently started taking that were never added to the list.
It’s even possible two or three different drugs on the list are all used to treat the same exact problem… because old ones were never removed. Worse still, drugs you had a bad reaction to in the past could still be on the list. And to make the point sharper, this information is not easily accessible to other medical providers.
Let’s say you visit Dr. Welby. He asks if you’re still taking a certain drug on the list. You tell him that Dr. House told you not to take it anymore. Then Dr. Welby says “yeah, but you really need it, so start taking it again,” never knowing that Dr. House replaced it with a similar med. (Or maybe it was removed because it interacted with another med.)
So you can blame a lot of prescribing errors on all of the different doctors, walk-in clinics and hospitals you go to who have their own birds-eye view of things, or just lack updated information.
There is also something that we call a “cascading effect.”
This is something that happens when you are prescribed one medication, and then prescribed another to offset the side effects of the first one. This can produce further new symptoms, and result in additional prescriptions.
The next thing you know there are multiple issues, because the additional meds amplify the side effects of the original drugs and lead to toxicity.
I’ve also seen situations where a doctor switches the patient from one drug to another; but the patient never realizes they are supposed to stop taking the old one.
These are all things that can lead to polypharmacy and place your health at risk.
Take Control of Your Medications!
The more medications you take, the greater the risk of side effects and the greater the likelihood multiple drug interactions. Confusion, cognitive decline, dizziness, poor balance and falls, frailty, weakness, loss of appetite and liver or kidney failure are some of the symptoms.
That being said, it’s up to you to take control of your medications.
Always carry a list of the medications you are taking, including over-the-counter meds and supplements. Include dosage and frequency. Keep it up-to-date, and give a copy to a family member as a back-up. This will come in handy if you ever have to go to the emergency room.
Have your doctor review your meds with you. At least once a year, it’s a good idea to throw all of the meds you are taking into a bag and take them with you to the doctor’s office. Have him or her look at each one, explain why you are taking it, and what the side effects are. If you are overprescribed, this is where some drugs may be weeded out for discontinuation.
Ask if any of your drugs are on the Beers Criteria. This is a list of medications that are generally considered inappropriate for use among older individuals. You can see which medications are on the Beers Criteria here.
If you physician fails to work with you, or doesn’t know how to “de-prescribe,” your best bet is to find a certified functional medicine doctor like myself.
We’re trained to widen our lens and take in every aspect of your health; sort of a 30,000-foot view. This means we spend a lot of time talking to you. We dig deep into your history to find the underlying causes of your problem… and actually correct it upstream, so that your symptoms resolve on their own downstream.
You can easily find a functional physician in your area at the Institute for Functional Medicine’s website.
Look for one who is an MD or DO, and make sure he or she has the certification IFMCP. Call and talk to them before scheduling an appointment to make sure they’re really practicing functional medicine… and not just “trying it out.”
SOURCES:
Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014 Jan;13(1):57-65.
Chang TI, Park H, Kim DW, Jeon EK, Rhee CM, Kalantar-Zadeh K, Kang EW, Kang SW, Han SH. Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study. Sci Rep. 2020 Nov 3;10.
