Polypharmacy - What to Know!
Every time I see a new patient, I like to get a thorough review of their
medication list, especially if they are older than 65. Several times I
have had the experience where a patient tells me: “my previous doctor
gave me Drug A for my complaint, and Drug B for the side effect of Drug
A, and Drug C for the side effect of Drug B…” and the list
continues on and on like a chain of trains.
Polypharmacy is a term used to describe the situation where a patient
is prescribed a multiple and alarming or unnecessary number of uncoordinated
medications (prescriptions and over-the-counter). Polypharmacy is most
common in the elderly, affecting about 40% of older adults living in their
Polypharmacy often occurs because the patient may be under the care of
multiple physicians without having a primary doctor who coordinates all
their health care. A person sees three different doctors and gets three
different prescriptions. These prescriptions may interact with each other,
causing side effects (sometimes dangerous) or they may work against each
other, eliminating the benefit of the medication.
The good news is that there are multiple resources available to check
your medication list for possible interactions and side effects. Here
are some ideas to avoid interactions if you find you (or someone you love)
has a polypharmacy situation:
Keep a list. Bring a list of all your current medications including vitamins
and over-the-counter items to all of your appointments and show it to
your care providers. Ask them to check the list for any possible complications
and remember to also ask if any of your symptoms might really be side effects.
Go online. There are many websites you can check to see if there are potential
problems in your polypharmacy regimen. To learn detailed information about
a medication, go to Drugs.com and search their drug index at
http://www.drugs.com/drug_information.html. This site will also help you look for potential drug interactions.
Appoint a lead physician. Ask a family practitioner, internist or a geriatrician
to be your "lead physician." As part of this role, that doctor
will evaluate your care from all your other doctors, review your medications,
and make phone calls to coordinate care when necessary. Sometimes all
you need to do is to let a doctor know that you would like this level
of involvement in your care.
Ask your pharmacist. Pharmacists are trained to look for drug interactions
and other problems - but they can only do that if they have all your information.
Hand them your polypharmacy list and ask them to look it over. This is
especially important if you get your medications at more than one pharmacy,
as all the information won't be in one place.
Medications work wonderfully if taken and managed appropriately. It is
very important to have a primary care doctor to coordinate your care,
especially if you have multiple chronic medical conditions and other specialty
physicians involved in your health care.