The Risks of Polypharmacy


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What is Polypharmacy?

The Centers for Disease Control and Prevention defines polypharmacy as taking 5 or more medications at the same time. Polypharmacy is more common in older adults who often have multiple chronic medical conditions. This includes arthritis, asthma, COPD, heart disease, elevated cholesterol, depression, diabetes, and hypertension.  Among adults (between 60-79) the most common types of prescription drugs in the United States are lipid-lowering drugs (45.0%), agents to combat diabetes (23.6%), beta blockers (for high blood pressure or heart disease, 22.3%), ACE inhibitors (for high blood pressure, heart failure, stroke prevention, and treating kidney disease, 21.3%), and proton pump inhibitors (to reduce the production of stomach acid, 16.9%). 


The Risks of Polypharmacy

Polypharmacy does not always bring negative consequences but there are certain risks and the impact to seniors can be significant. In fact, according to the National Institutes of Health, polypharmacy can lead to:

  • Greater health care costs
  • Greater chance of an adverse drug event (ADE)
  • Drug interactions
  • Not taking medications properly
  • Skipping doses due to high costs of multiple medications
  • Decline in function
  • Cognitive impairment
  • Falls
  • Poor nutrition
  • Urinary Incontinence
  • Taking unnecessary medications
  • Adverse symptoms of medication mismanagement mistaken for normal signs of aging
  • A burden to both the patient and family to manage medications on a daily basis


Part of the problem of taking several medications is that seniors often visit multiple doctors or clinics to receive treatment for different conditions. As a result, each provider may overlook the whole picture and focus on writing a prescription for a particular medical issue. In addition, if a patient has not written down a complete list of medications and doses (and relies solely on memory) a doctor will not have all the information needed to properly prescribe a new drug to ensure it won’t negatively react with existing medications. Furthermore, patients who fill prescriptions at multiple pharmacies or through mail order locations run the risk of not having a single record of all medications.



Reducing Negative Consequences

Here are some guidelines from the National Institute on Aging to help guide you or a senior loved one to safely manage medications:

  • Write a complete and accurate list of every prescription, vitamins, and any over-the-counter medications you are currently taking. Make sure to include dosage. Keep the list with you, stored in your phone, and in your car. Also post on your refrigerator and give a list to a family member or friend.
  • If possible, put all your medications in a sealed plastic bag and take with you to your next appointment. This will provide your doctor with an accurate visual of all your medications and will ensure no drug has been left out of a written list.
  • Discuss any new symptoms with your doctor. Most importantly, ask if any of the current drugs you are taking could be causing these symptoms.
  • When prescribed a new medication take notes about any other special instructions. If you are taking other medications, make sure your doctor knows what they are to help prevent harmful drug interactions.
  • Understand why a drug has been prescribed for you. Your doctor or pharmacist should be able to answer this question: What is the evidence of this medication actually helping your condition?
  • Consider potential harms from the medications. Ask questions like, “Can this drug affect my memory?” “Can this drug increase my risk of falling?” Then have a discussion with your doctor about whether these benefits and risks make sense, and if not, if there are alternative options.
  • Check with your doctor before taking any over-the-counter medications.
  • Keep in mind your goals and those of your caregiver and what matters to you both in terms of quality of life.




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