What Does Polypharmacy Mean?

Patients admitted to a rehab or nursing home take an average of 15 medications!  Although seniors make up 13% of the population, they consume 30% of all prescription drugs, leading them and their families to often ask, “Why so many drugs?”

Polypharmacy is a recognized problem in geriatrics and has been defined as the use of multiple medications and/or the administration of more medications than are clinically indicated; some authorities define it as when more than four drugs are taken.

The following evidence suggests we have reason to be concerned:

When those over 80 years of age have an Adverse Drug Event, 25% need admission to hospital
14-52% of seniors take at least one inappropriate medication (such as a Beer’s List drug – discussed next time). For every dollar spent on a prescription, it triggers a dollar spent on iatrogenic illness (physician-induced problems).

Why are drugs such a problem for seniors?
Seniors are not simply ‘older’ adults.  As we age, our metabolism slows and changes:  the liver and kidney don’t filter toxins as well; our fat distribution is different (affecting drug storage); our brains are smaller and are more sensitive to drugs.

These changes in physiology result in frequent problems when taking medicines:  an increase in falls and fractures; a greater frequency of confusion or delirium, malaise [“don’t feel good”], constipation, indigestion, aching, drowsiness.

In general, seniors feel better on fewer drugs.  Next time:  Which drugs are often a problem?