What is the reason behind increase in the consumption of pills?
The prevalence of the use of prescription medication among older adults i.e. 62 to 85 years old has
increased over the past few years. Polypharmacy i.e. concurrent use of 5 or more prescription
medications has also increased during this time.1,2 A major reason for this increase is that patients
receiving specialized care are required to visit multiple healthcare providers and those providers may
not be aware of the medicines and supplements that have been prescribed or recommended by their
Are we overmedicating?
Problems caused by taking too many medicines
Taking too many medicines can lead to several issues, including:6
Increased risk of Adverse event- A study reported that outpatients taking 5 or more medications had an 88% increased risk of experiencing an adverse event compared to those who were taking fewer medications.
Drug Interactions- In older hospitalized adults taking 5 or more medications, the prevalence of a drug-drug interaction was 80%. Drug-drug interactions are a frequent cause of medication-related hospitalizations.
Poor Nutrition – Taking too many medicines affects a patient’s nutritional status. 50% of those taking 10 or more medications were found to be malnourished or at risk of malnourishment.
Trouble thinking or Doing daily activities – Taking too many medicines can cause cognitive impairment or diminished ability to perform daily activities.
Urinary Incontinence - Use of multiple medications was associated with an increased risk of lower urinary tract symptoms.
Increased healthcare Cost- Polypharmacy may cause an increased risk of taking a potentially inappropriate medication and an increased risk of outpatient visits and hospitalization with an approximate 30% increase in medical costs
Increased risk of Falls - Increased number of medicines were associated with increased risk of falls
In addition, taking too many pills has been associated with non-adherence in older adults. In fact, most people who take medicines for chronic diseases stop taking them or take less than was prescribed. This can lead to worsening of the disease, hospitalizations, treatment failure, and adverse events6
Steps to make sure you’re not taking medicines or supplements you don’t need
Whether you take prescription medicines, over-the-counter medicines, supplements, or a combination of these, it’s important to work with all your healthcare providers to ensure that you take only what is necessary for you. Here are tips to help you get started:7-10
- Make sure that all your doctors know about every medicine you are taking
- Keep a list of all the medicines you take, including prescription medicines, over-the-counter medicines, and supplement. Keep a “medicine calendar” with your pill bottles and note each time you take a dose
- Ask your healthcare provider why he or she has prescribed a medicine (or medicines) for you. For example, ask if it is to treat a medical condition, how to take it properly, and how long you need to take it
- Ask your healthcare providers for a review of everything you take. Bring all your medicines (prescription, over-the-counter medicines, supplements, herbal products) to your next appointment with your healthcare provider. It’s best to keep them in their original containers. He or she can review them to help determine that all medicines are necessary and can be taken together
- Ask your pharmacist any questions you may have about the medicines and supplements you are taking
- Have a “Medicine Check-Up” at least once a year. Go through your medicine cabinet to get rid of old or expired medicines and ask your doctor or pharmacist to go over all the medicines you now take
- Qato DM, Wilder J, Schumm LP, Gillet V, Alexander GC. Changes in prescription and over-the- counter medication and dietary supplement use among older adults in the United States, 2005 vs 2011. JAMA Intern Med. 2016;176(4):473-482.
- Shah BM, Hajjar ER. Polypharmacy, adverse drug reactions, and geriatric syndromes. Clin Geriatr Med. 2012;28:173-186.
- Marcum ZA, Gellad WF. Medication adherence to multi-drug regimens. Clin Geriatr Med. 2012;28(2):287-300.
- Salive ME. Multimorbidity in older adults. Epidemiol Rev. 2013;35:75-83.
- Kantor ED, Rehm CD, Haas JS, Chan AT, Giovannucci EL. Trends in prescription drug use among adults in the United States from 1999-2012. JAMA. 2015;314(17):1818-1831.
- Maher RL Jr, Hanlon JT, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014;13(1):1-11.
- Agency for Healthcare Research and Quality. 20 Tips to help prevent medical errors: patient fact sheet. [internet]. Ahrq.gov. 2019 [cited 28 June 2019]. Available from https://www.ahrq.gov/sites/default/files/wysiwyg/patients-consumers/care- planning/errors/20tips/20tips.pdf
- Taking control of your medicines [Internet]. www.heart.org. 2019 [cited 28 June 2019]. Available fromhttps://www.heart.org/en/health-topics/cardiac-rehab/managing-your-medicines/taking- control-of-your-medicines
- Counsel on family health. Medicines and you. A guide for older adults. [Internet]. Acl.gov. 2019 [cited 28 June 2019]. Available from https://acl.gov/sites/default/files/news%202018- 01/MedandYouEng_0.pdf