Polypharmacy: An Unnecessary Treatment For Chronic Diseases
Polypharmacy, simultaneously using different medications, has become a common trend for many individuals suffering from multiple chronic diseases. Although polypharmacy is becoming increasingly prevalent in modern medicine, it greatly augments the risk of hospitalization from detrimental reactions between incompatible drugs. This risk is especially exacerbated in older adults as their bodies are weaker, making it significantly harder for them to mediate such damaging interactions. Adverse drug reactions are serious—they are the seventh leading cause of death in American adults over the age of 65.
A recent study conducted in Denmark sought to uncover new ways to decrease the incidence of polypharmacy reactions in older adults. Since chronic diseases are usually treated by general doctors, also known as general practitioners (GP), this study focused on their patients. In their study, the researchers asked doctors to identify a patient that was both at least 65 years old and prescribed six or more medications. Following this, the doctor would send this patient’s medical information to a medication management team composed of physicians and pharmacists. The team reviewed the patient’s record and looked for unimportant medications related to managing old or creating new side effects that could be removed if needed. This trend is cyclic. For example, if a medication to treat back pain causes abdominal pain, a patient will likely ask for an additional medication that will alleviate this side effect. The medication that treats abdominal pain may lead to other side effects, and thus even more medications. In this sense, the medication management team would recommend the GP substitute the original back pain medication for one with less side effects.
A recent study conducted in Denmark sought to uncover new ways to decrease the incidence of polypharmacy reactions in older adults. Since chronic diseases are usually treated by general doctors, also known as general practitioners (GP), this study focused on their patients. In their study, the researchers asked doctors to identify a patient that was both at least 65 years old and prescribed six or more medications. Following this, the doctor would send this patient’s medical information to a medication management team composed of physicians and pharmacists. The team reviewed the patient’s record and looked for unimportant medications related to managing old or creating new side effects that could be removed if needed. This trend is cyclic. For example, if a medication to treat back pain causes abdominal pain, a patient will likely ask for an additional medication that will alleviate this side effect. The medication that treats abdominal pain may lead to other side effects, and thus even more medications. In this sense, the medication management team would recommend the GP substitute the original back pain medication for one with less side effects.
Using many medications can increase the chances of them interacting with each other, potentially causing adverse reactions and death.
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The team determined four recommendations when changing medications: discontinuation, reduction of dose, increase of dose and change of medication. Afterwards, the team sent this revision to a medical consultant who then presented the recommended changes to the patient’s general practitioner. The results of the study found that nearly half (48%) of prescriptions were changed and that there was at least one recommended change for a medication for every patient. The study also concluded that acetaminophen—the active ingredient in medications like Tylenol—was prescribed most frequently. Fortunately, many GPs accepted these recommendations, ideally leading to enhanced life quality for numerous patients.
Although this study was conducted in Denmark, it is easily applicable to the United States (US). The US overall population is rapidly aging: approximately 20% of the country will be 65 years or older by 2030, and there will be 83.7 million adults ages 65 and older in 2050. Furthermore, 30% of older Americans take five or more medications—undoubtedly leading countless to die from adverse medication interactions. Doctors should review patient prescriptions and records to determine if any medications are leading to more medical problems and are decreasing the life quality of their patients.
Although this study was conducted in Denmark, it is easily applicable to the United States (US). The US overall population is rapidly aging: approximately 20% of the country will be 65 years or older by 2030, and there will be 83.7 million adults ages 65 and older in 2050. Furthermore, 30% of older Americans take five or more medications—undoubtedly leading countless to die from adverse medication interactions. Doctors should review patient prescriptions and records to determine if any medications are leading to more medical problems and are decreasing the life quality of their patients.
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