What is the reason behind the increase in consumption of pills?
The use of prescription medication among older adults between 62 to 85 years old has increased over the past few years. Polypharmacy which means 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 peers.3
Are we overmedicating?
Chronic diseases are the leading cause of deaths in Malaysia4
39% of adults aged 65 years or older take five or more medicines5
59% of adults aged 65 years or older take unnecessary medicines6
Things to do before stopping your medications abruptly
Stopping your medication abruptly may not only adversely affect your condition, it can be very dangerous:6
Talk to your doctor first - Discontinuing a medication abruptly can be associated with unpleasant side effects and worsening of symptoms based on your drug treatment and how your drug is broken down and excreted from the body.
Discuss your medications - Roughly 40 percent of people over the age of 60 take at least five prescription drugs, including medications they no longer need. You can discontinue medications if agreed by your treating doctor.
Stop for the right reasons - Not taking your medicines can lead to worsening of chronic conditions and increased hospitalizations. Many people think they can stop their treatment when they feel better, but this is usually not the case. Not only will your condition worsen, you may experience side effects from abrupt medication withdrawal.
Chart Your Discontinuation Plan - You may need to switch drugs due to side effects or lack of effectiveness. For this, you may switch drugs immediately or start the new drug at a lower dose while slowly tapering off the first drug. However, this is not always the case, always ensure you consult with your prescribing doctor.
In case of too many pills prescribed, most people who take medicines for chronic diseases stop taking them or take less than what was prescribed. This can lead to worsening of the disease, hospitalizations, treatment failure, and adverse events.7
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:8-11
- 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 supplements. 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.
- Malaysia [Internet]. Institute for Health Metrics and Evaluation. 2019 [Cited 3 October 2019]. Available from http://www.healthdata.org/malaysia
- 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.
- Top 6 Safety Tips for Stopping Your Meds [Internet]. Drugs.com. 2019 [Cited 26 August 2019]. Available from https://www.drugs.com/article/safety-tips-stopping-meds.html
- 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 Jun 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 Jun 2019]. Available from https://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 Jun 2019]. Available from https://acl.gov/sites/default/files/news%202018-01/MedandYouEng_0.pdf
- Why You Need to Take Your Medications as Prescribed or Instructed [Internet]. U.S. Food and Drug Administration. 2019 [Cited 28 Jun 2019]. Available from https://www.fda.gov/drugs/special-features/why-you-need-take-your-medications-prescribed-or-instructed