Medication – Too Many Prescriptions with Too Little Monitoring
Too Many Medications
Taking too many medications can be very dangerous. This is especially prevalent in geriatric patients. You get a prescription for prediabetes, and another for high cholesterol based on the results of a blood test. Then, as medical conditions multiply, so do your medications. Too many different drugs can lead to hard-to-detect and dangerous drug interactions. When you add over-the-counter vitamins, minerals, and supplements, it becomes even more dangerous.
It is important that we take responsibility for knowing what we are taking, investigating them, relying on trusted advisors, informing our doctors, and then making sure that our doctors, pharmacists, and specialists are aware of anything we take.
Often, our doctors don’t know we’re taking supplements, they may also not know what other doctors are prescribing. Each medication comes with risks and side effects, They multiply with the number of drugs that are being taken and can interact. The more drugs you take, the more likely it is that there will be problems with negative and even deadly effects.
Prescription Drug Use
Prescription drug use varies by age, gender, race, ethnicity, and health status. Prescription drug use increase with age. People with chronic conditions take more prescriptions. From an old study https://hpi.georgetown.edu/rxdrugs/
| Age | % Using Prescriptions | Average Annual Prescriptions |
| 18-34 | 53 | 3 |
| 35-49 | 62 | 6 |
| 50-64 | 75 | 13 |
| 65-79 | 87 | 20 |
| 80+ | 91 | 22 |
| Gender | ||
| Male | 56 | 7 |
| Female | 75 | 11 |
| Race | ||
| White | 68 | 10 |
| Black | 58 | 8 |
| Ethnicity | ||
| Not Hispanic | 67 | 10 |
| Hispanic | 53 | 5 |
| Annual Family Income | ||
| <$20,000 | 72 | 13 |
| >$55,000 | 63 | 7 |
| Health Status | ||
| Excellent/Very Good | 59 | 5 |
| Fair/Poor | 87 | 24 |
What We Can Do
International research shows that polypharmacy is common in older adults with the highest number of drugs taken by those residing in nursing homes. Nearly 50% of older adults take one or more medications that are not medically necessary. Research has clearly established a strong relationship between polypharmacy and negative clinical consequences. Moreover, well-designed inter-professional (often including clinical pharmacist) intervention studies that focus on enrolling high-risk older patients with polypharmacy have shown that they can be effective in improving the overall quality of prescribing with mixed results on distal health outcomes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864987/
By managing our medication together with your well-care team, you can reduce the chances of bad health outcomes.
- Make a detailed medication list. It should include the name, strength, dosage, instructions, and any listed cautions.
- Carry the detailed medication list with you.
- Give the list to all of your doctors, and your pharmacist.
- Update your list as you add or remove prescriptions and over-the-counter supplements.
- Keep a file with all of the Medication inserts and instructions.
- Use one pharmacy to fill prescriptions.
- Schedule reviews regularly with your pharmacist and/or general doctor.
- Ask questions:
- why is the medication prescribed?
- is there a lifestyle change that can be made instead of taking the prescription?
- how does the medication work in the body?
- what are common and rare side effects?
- how long does it take for the medication to work?
- are there activities the medication will interfere with?
- Is it safe to drink alcohol with this medicine?
- how necessary is the medication?
- can the dosage be reduced?
- are medications interacting in a negative way?
- could the medications be the cause of other symptoms?
- can a medication be removed after a period of time?
Lifestyle changes can sometimes eliminate the need for drugs. Ask your doctor if you can go home for three weeks and cut out candy from your diet or give up your daily smoked sausages before you agree to get on a life long prescription of medication. Your doctor can retest after the changes are made and see if it’s working.
Don’t be afraid to ask for a second opinion.
Your wellness team should be eager to help you to keep all of your medication straight and to ensure that you don’t have a potentially lethal combination of drugs. Don’t be afraid to ask for help and if it isn’t forthcoming, don’t be afraid to look for a wellness practitioner who is willing to help you.
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Wow, people my age take a lot of prescriptions! I don’t know how they remember all of them! My parents, even in their 90s, never took quite that many and I, at the age of 65, take two. I put a red rubber band on the morning pill bottle and a blue rubber band on the evening pill bottle. Fortunately, that’s it or I could run out of colors!
It’s so scary to think about taking medications then needing more medications to treat side effects. I also hadn’t thought about the fact that doctors may not always know everything a patient is taking because they are seeing different docs for different ailments, certainly seems like a disaster waiting to happen. Thanks for posting this and creating more awareness around it.
Too many docs treat symptoms and not the patient. That’s how the scrips accumulate.