Less is more. This is typically true with prescription medication. Although some medications are lifesaving, many people in this country are overmedicated, especially older adults. The term is called polypharmacy. According to the American Society of Consultant Pharmacists, 65-69 year olds take an average of 14 prescription drugs per year, and by the age range of 80-84 that average increases to 18 prescription drugs per year. The cost of overmedication with the elderly population is estimated at $80 billon annually (http://www.healthwatchersnews.com/2010/10/when-seniors-are-over-medicated/).
When it comes to our health, Americans typically go to specialists, and each specialist will add prescriptions as deemed necessary: cardiologists treat an assortment of cardiovascular conditions; an endocrinologist treats conditions such as diabetes; a gastroenterologist commonly treats reflux; orthopedists may prescribe pain medications or muscle relaxants; the psychiatrist treats various psychological disorders, and the list goes on. People commonly end up with a long list of medications without understanding how they all interact. Although originally prescribed to help, often these drugs end up causing additional complications such as loss of mobility, falls, depression, constipation, cognitive decline or even cardiac issues. Too often, additional medications are added to treat these complications.
But the doctors prescribing medications are not the only reason elderly people are often overmedicated. Elderly people tend to have more chronic conditions and go to their physicians seeking a solution and often wanting immediate results. We are a pill-popping society. Too many people refuse to change their diet, do not exercise regularly and fail to make other lifestyle changes that will improve their health.
In my experience as a health consultant, our elderly population is experiencing poorly coordinated care. It is a challenge to navigate the health care system; all of us benefit by having an advocate who can listen, ask questions, and assist with an office visit or admission to a facility. Older adults often have multiple conditions, they see multiple doctors, and they often transfer from home, to hospitals, to rehabilitation, and the cycle starts all over again – sometimes ending with nursing home or long-term care services at home. Along this complex path, prescription medications are often added or deleted and confusion and errors too frequently occur. In addition to prescription medications, people take over-the-counter medications. Elderly people are more sensitive to the side effects of medications and they metabolize medications differently than younger people. Complications with medications often result in emergency room visits with 30% of hospital admissions of elderly patients being related to medication side effects or complications (http://www.aafp.org/afp/2013/0301/p331.html).
Prescribing medications requires clinical judgment. A decision has to be made as to whether the benefits of the medication outweigh the risks. According to gerontologist, Dr. R. Pretorius, prescribing medications is not solely a medical decision; one has to consider functional, social, and quality of life issues (http://www.aafp.org/afp/2013/0301/p331.html).
The following approaches can help prevent overmedication and complications for elderly patients:
1. Establish a relationship with a primary physician, who can oversee your care and coordinate your medication schedule
2. Utilize one pharmacy and establish a relationship with the pharmacist to assist with questions about medications
3. Consider seeing a gerontologist to make an assessment if your medication regimen is complex
4. Become informed about your medications so you can report adverse effects and question doctors when they want to add or change your medications
5. Consider hiring a consultant or advocate if you are hospitalized and in need of follow-up services, if your medication regimen is complex, and/or you don’t have anyone to advocate for you
6. Compile your own medical record: Include a summary page that includes pertinent health information such as diagnoses, surgeries, injuries, medication list, allergies, adverse effects of drugs, lifestyle habits, etc. Use this as a reference when you visit physicians.
Too much medication with our elderly population is a serious public health issue, and it is contributing significantly to health costs. Elderly people are suffering and missing out on opportunities in their everyday lives.
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