Polypharmacy I

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 minimize 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 nursing homes take on average 15 medications.  It’s estimated that by 2040 seniors will comprise 25% of the population and take 50% of prescriptions! 

Why so many drugs?
1) Physicians are trained to cure problems and help patients.  Pharmaceutical efforts have made thousands of drugs available to assist in this.

2) Drugs have cured or relieved many previously incurable conditions, helping people with chronic conditions to live longer and better.  Therefore, everyone concludes (falsely) ‘more must be better’.

3) TV advertising directed at patients promotes a “pill for every ill”, encouraging people to ask for a specific prescription.  [only the USA and New Zealand allow such advertising]

4) Medical training produces mostly specialists, who focus on their own area, following guidelines that promote a specific treatment for each disease, resulting in multiple therapies when you have several diseases; rarely does anyone ask what might be best for the ‘whole’ patient. 

5) Physicians rarely discontinue drugs prescribed by another—resulting in an accumulation of pills.

6) Doctors worry they’ll be sued if they haven’t done ‘everything’ to keep a patient happy and alive.  That means following Clinical Practice Guidelines [CPG] on how to treat a particular disease and which drugs to use.  (However, if they’ve discussed the patient’s goals and documented that the recommended CPG’s are inappropriate for that patient, their risk is minimized or eliminated).

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