Polypharmacy refers to the taking of multiple drugs by a single patient. Doctors and clinicians usually use this term to refer to a problem which develops as a result of taking multiple drugs. As more and more drugs are being developed to treat diseases and conditions associated with aging and to potentially even extend life, clinicians are observing an increasing number of drug interactions as well as an increase in potentially adverse health-related problems due to these interactions. Not surprisingly, it is the elderly who are most affected by polypharmacy, as older adults account for the bulk of prescriptions sales. However, prescription medications are only part of the problem. To prevent side effects caused by these interactions, patients, pharmacists and physicians must work collaboratively to regularly review the patient’s entire medication list.
There are many factors which contribute to this polypharmacy problems. Following are five of the most common contributing factors:
- Multiple doctors and pharmacists. Many seniors have more than one doctor involved in their care. Multiple physicians sharing a patient may or may not be familiar with the patient’s entire list of drugs, which creates the potential for one physician to prescribe medications which will have adverse effects with other drugs prescribed by another physician. Similarly, it has been reported that up to a third of all seniors use more than one pharmacy to fill their prescriptions. The individual pharmacies cannot be responsible for overall drug monitoring if they are unaware of the patient’s complete list of medications.
- Over-the-counter drugs. The proliferation of previously prescription drugs which are now available over the counter creates more potential conflict. Seniors oftentimes believe that over-the-counter medications do not require disclosure to their doctors or pharmacists. But these drugs, while they don’t require a prescription, are just as likely to cause interactions with other over-the-counter medications as well as prescription medications. Additionally, these drugs must be considered when the doctor attempts to decipher the puzzle of new symptoms. This is especially true with the ever-evolving proliferation of new drug formulations of the same drugs, which require different frequencies of taking these drugs, such as with extended-release drugs.
- Supplements and herbal products. Alternative drugs, including herbal products and food supplements, also add major potential for interactions with prescribed drugs, and may confuse the situation to an even greater degree.
- Drug interactions and reactions. A bad reaction to a particular drug may be interpreted as a new disease state or a new condition, and thus an additional drug can be prescribed for that “new disease,” which may compound existing problems.
- Doctors don’t have enough time. Unfortunately, the structure of modern group medicine in the US means that many physicians do not really have the time to delve into the complexity of the polypharmacy problem, especially when they are not even aware of the all the products that a particular patient is taking.
With all of this in mind, the best thing that patients and caregivers can do is to carry a written copy of the patient’s entire drug list at all times, and be responsible for informing each person in the chain of the patient’s health care of each drug he or she is taking, along with the frequency and dosage. Don’t forget to include herbal treatments and food or vitamin supplements as well as all over-the-counter medications. Disclosing this information every time you deal with the patient’s doctor and pharmacist will help you avoid needless and potentially harmful drug interactions. If you are concerned that your loved one is having trouble with his or her medications, read more about the risk factors of medication-related problems and talk to the patient’s doctor, with full disclosure.