Polypharmacy Factors Pt 1

Many seniors and their families question the number of pills they take.  This begins a series on why everyone should be concerned, which drugs are particularly worrisome, and what can patients do to reduce the number of medications and the risk of side-effects:  Polypharmacy #1. 

Background facts:  Seniors make up 13% of the population but take 33% of all prescriptions.  Those admitted to a local rehab or nursing home take on average 15 medications.  It’s estimated that by 2040 seniors will comprise 25% of the population and be taking 50% of prescriptions!

Why so many drugs are being prescribed and taken.

Physicians are trained to cure problems and help patients.  Pharmaceutical research & marketing has made thousands of drugs easily available—so treatment now almost always includes medications.

Drugs have cured many previously incurable conditions, and helped many people with chronic conditions to live longer and better.  With such success, everyone concludes ‘more must be better’.

TV advertising directly to patients promotes a “pill for every ill”, a quick and easy fix, and encourages people to ask for a specific prescription.

Medical training produces mostly specialists.  Each specialty, focusing on its own area, follows guidelines that promote a specific treatment for each disease, resulting in multiple therapies when you have several diseases; but, rarely does anyone ask what might be best overall for the (‘whole’) patient.

Physicians rarely discontinue drugs prescribed by another, resulting in an accumulation of pills.

Doctors worry they’ll be sued if they can’t show they’ve done ‘everything’ to keep a patient happy and alive.  Clinical Practice Guidelines [CPG] are telling doctors the best treatment for a particular disease.  Physicians who don’t follow these guidelines could be sued if something bad happens (unless they’ve discussed the patient’s goals and documented that the recommended CPG’s are inappropriate, in which case their risk is minimized or eliminated).

Next:  #2. Polypharmacy and the risk of side-effects.