Healthy Headlines - Polypharmacy

8/2/2013

“I have way too many pills!!” 

                This statement is usually yelled with great emotion and rightly so.  The term polypharmacy means the use of multiple medications by a patient (usually the patient who is over the age of 65).  By definition, polypharmacy is the use of five or more medications by an individual.  With the advance of medications, blood tests, and radiography people are living longer.  The resulting diagnosis and early treatment of disease has improved as well.  With this advancement comes with it other potential concerns.  One of the concerns that we’ll discuss is polypharmacy.

                Sometimes the term polypharmacy is used to mean unnecessary or excessive amounts of prescriptions.  However, when a person has multiple medical issues it can be necessary to be on multiple medications.  You and your physician will need to determine what medication regimen would be considered, “unnecessary or excessive.”  One of the quickest and easiest ways to avoid polypharmacy is bringing your medications with you at your appointment.  These medications include prescriptions, over-the-counter medications, herbs/supplements, and any, “as-needed” medications.  If you see several other physicians for your care (this includes cardiologists, nephrologists, dermatologists, etc.) bring the medications they have started for you as well.

                If you are uncertain what medication does what for you (and potential side effects) consider going over your current medications with your physician at that time.  It helps to understand the basics regarding your medications.  It is also helpful to know some of the more common side effects of your medications as well.

                The potential for a person to experience side-effects from a medication usually cannot be predetermined.  However, discussion with your doctor and close observation of current medical conditions provide the best possible medication intervention.  In other words, you and your doctor have to have open communication about your current medications and your current medical condition.  If you feel bad and the medication makes it worse feel free to explain these changes with your doctor.

                Over-the-counter medications may also play a large role in regards to polypharmacy.  Many current over-the-counter medications were once by prescription only; omeprazole, loratidine, and cetirizine to name only a few.  These and other over-the-counter medications can provide a very good service but they also have potential side effects and may counter-act with other medicines provided by your doctor.  Other medications may be contraindicated due to other medical conditions.  For example, people with a diagnosis of high blood pressure typically need to avoid products that contain pseudoephedrine.  Before starting any over-the-counter medications consider speaking with your physician or healthcare provider.  Again, this is why it’s always a good idea to bring in your over-the-counter medications to your appointment. 

                Prior to your appointment with your physician don’t forget to bring with you any herbs or supplements.  The supplement/herb market in this country alone is a multibillion dollar machine.  These products are not currently being regulated by the FDA.  There has been an ongoing debate on their usefulness as well as safety with these products.  Again, be sure to bring them with you to your appointment.  Some of the more popular products include, red yeast rice (Monascus purpureus), saw palmetto (Serenoa repens), and St. John’s wort (Hypericum perforatum) to name only a few.  For many people these herbs and supplements have helped by improving their overall health; just keep in mind to notify your physician in regards to your current herb/supplement regimen.

                As-needed medications frequently include any pain-medicine, medications for headaches, gastrointestinal medications, sleep-aids, and any topical medications to name only a few.  These too provide a service to the consumer but also can contribute to potential ill-effects.  Be sure to bring these with you as well. 

                Compared to the general population folks that are aged 65 years and older traditionally run an increased risk of polypharmacy.  For some individuals multiple medications may be necessary due to ongoing medical conditions.  For others, a close evaluation and ongoing reevaluation may provide improved insight with your current medication regimen.  Consider bringing your medications with you during your office visits (this includes over-the-counter medications, herbs/supplements, and as-needed medications).

                Together you and your physician can create a medication regimen that not only will assist you with your current medical condition but also minimize any potential for adverse effects.  Consider this intervention and consider it an ongoing exercise to keep you happy and healthy.  To the reader, I wish a wonderful month of August and continued good health.   

                As with all medical conditions, always feel free to contact your physician or healthcare provider with any questions or concerns.

                Dr. Charles Weintz is the author of, “Healthy Headlines.”  He is a family physician at Stanton County Family Practice.

 

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