Polypharmacy VII

This is #7 in the series about why we should be concerned with seniors taking so many pills:   Tips to reduce Polypharmacy.

A study in 2010 [Archives of Internal Medicine] showed it’s possible to reduce the number of drugs seniors take—without causing any major problems.

For each medication, six questions were asked:

1) “Is there good evidence to use the drug at its current dose and do the benefits outweigh known side-effects?”  If “yes”, then the drug was continued.  But, if the answer was “no or not sure”, the researchers asked the next five questions below, which, at each step, could result in stopping the drug, trying a different one, or ‘make no change’.

2) Is the reason for using the drug appropriate in this age group and disability level?

3) Do the possible side-effects outweigh the benefits?

4) Are any side-effects present?

5) Is there another drug that may be superior?

6) Can the dose be reduced without significant risk? If the drug hadn’t been stopped or changed, then the same dose would be continued or the patient could try reducing it anyway.

Using this method, 58% of all drugs were discontinued (averaging 4.4 drugs per patient), with no bad outcomes.  The seniors, who averaged 82 years and 7.7 drugs, only had to restart 2% of drugs.

Anyone can do this, but preferably with your doctor’s support.  Clarifying your health goals will help decisions.  For example, if your goal is “live comfortably” and don’t want a lot of pills which may only add a few more months of possible suffering – the quality vs quantity issue—then you could stop all the ‘non-comfort’ drugs.

In general, it is a fact—confirmed in hospice—that generally seniors who take fewer drugs not only feel better but often live longer.