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What’s in your medicine cabinet? Issues around Polypharmacy

July 5, 2017

Shaina Toomey, MSPT, Director of Rehabilitation Services, Fresh River Healthcare Center

(appeared in the Windsor Locks Journal, Windsor Journal and Bloomfield Messenger)

Polypharmacy is a term to describe when individuals use multiple concurrent medications, generally 5 or more.  Although polypharmacy can be an issue for people of any age, it is generally a consequence of having several underlying medical conditions and is more common in people over the age of 65. According to information released by the CDC in 2010, in older Americans (aged 60 and over) more than 76% used two or more prescription drugs and 37% used five or more.

So what is the concern?

Unfortunately, there are many negative consequences associated with polypharmacy and is a rising concern among the healthcare community.  Every medication we take has a potential for adverse side-effects and many medications have a risk of interactions with other substances.  It is important to understand that interactions can be with other medications, herbal supplements, over the counter medications or even alcohol. The more medications that a person takes, the higher the risk of an interaction or complication.  Additionally, taking multiple medications has been associated with drug to disease interactions which can exacerbate a medical condition, medication non-adherence due to increased costs or dislike of taking “too many pills”, reduced functional capacity and increased hospitalizations. Often adverse reactions can be mistaken for the “normal” aging process or a side affect of a specific disease process.  Such reactions could be unsteadiness, falls, loss of appetite, confusion and urinary incontinence.  Be sure to be aware of the potential side affects of medications you are taking and always report any changes you experience to your doctor. 

How do we fix it? 

Polypharmacy often becomes problematic when patients are prescribed too many medications by multiple healthcare providers working independently of each other.  This can be compounded when we are self-treating with over the counter medications such as ibuprofen, laxatives, or even cold medicines. Drug-related problems are less likely to occur when one physician or nurse practitioner oversees your medication regimen.  If you have any specialist involved in your care, be sure they are communicating with your primary care physician.  Use the same pharmacy for all your prescriptions to allow the pharmacist to review interaction risks.  Lastly, it is very important to keep a detailed list of medications and dosages to provide to your doctor during a visit, including any over the counter medications.