Introduction
The repeated use of multiple prescribed medications — polypharmacy — can increase the risk for medication in older adults. With an increasing older population, there is an urgent need to bring about more rigorous safety methods to error practices in health care.
Healthcare providers act as critical safety nets against overmedication risks. While this requires some challenges to address, extremely useful techniques are available to help protect this vulnerable population against medication errors and provide healthcare growth.
What is polypharmacy?
Polypharmacy is the continual use of multiple prescription medications. By standard definition, it is the utilization of more prescription medications. The World Health Organization describes polypharmacy, as the concurrent use of multiple (more than two) medications by a patient to treat multiple health conditions.
At older age chronic conditions often require increased medications, or the patient in poor health may have one or more prescriptions for every single health need.
The higher the number of medicines a person takes to promote health or treat chronic illness, there is more chance of risks to overmedication, side effects, etc.
Common symptoms of polypharmacy can include:
Reduced alertness
Cognitive problems
Memory problems
Depression
GI issues
Anxiety
Falls and accidents
Low appetite
Weakness
Skin issues
Risks of Polypharmacy in Older Adults
- Drug Interactions
Older adults taking multiple medications may be at significantly higher risk of adverse reactions, specifically drug-drug interactions. Drug- interactions occur when medications interact with each other, or in the case of treating two or more health problems.
The medication to improve one health problem worsens another health condition. Drug-drug interactions pose health risks even if it is an acute or chronic health condition.
- Loss of Balance
Taking certain medications may also present an increased risk of loss of balance, potentially leading to serious, life-threatening, falls or household accidents. Medications with side effects, lower blood pressure can usually cause dizziness and imbalance.
In addition to sedating medications, anticholinergic medications, prescribed for urinary incontinence, heart conditions, Parkinson’s disease, etc may present an increased risk of imbalance.
- Oversedation
In older adults, especially those over 60, oversedation is another serious issue. It is caused due to the combined interaction of different and multiple drugs. This often causes drowsiness or confusion and may lead to accidents in or out of the home, or when driving.
- Adverse Drug Events
ADRs are a challenge for older adults taking many medications. They are harmful, unintended, and sometimes unpredictable responses to a medication.
An ADR may result from an uncontrolled, complex interaction of one medication with another, or in a particularly vulnerable older adult. It may present as a serious allergic reaction, organ damage, coma, or other serious negative outcomes.
Strategies to Reduce Polypharmacy in Older Adults
- Look for Incorrect Prescriptions.
Problems can sometimes arise due to wrong medications being prescribed, or the patient does not realize they should have stopped taking one drug when they started a new drug.
Maintaining an updated medicine list is a must. This is beneficial, not just for prescription but also for over-the-counter medications, vitamins, and supplements. Also, the dose of each medication and the time of day it’s taken. This ready list for physician visits, hospital admissions, or new providers helps in better healthcare service.
- Deprescribing
Deprescribing seems to be a very helpful healthcare strategy in the improvement of patient outcomes requiring a complex management process. Systematically discontinue medications that are no longer needed or that have a greater risk than benefit and taper them off with your prescribing health care provider.
- Contact with Pharmacist
Pharmacists are essential to the medication safety process. They are the final gatekeepers to mitigating prescriptions and potential interactivity. They are communication experts and can review a complete medication list, as well as herbs and supplements to determine areas of risk.
If you take more medicines, it may be worth having a good relationship with your local pharmacist. You ask questions when you are uncertain about what you should be taking, or when you should be taking it. This makes you more informed and avoids the risks of unnecessary medication.
- Patient Education
When patients are educated about their medications, they are equipped to understand what they take, and the purpose for their care. Also, involved in making appropriate decisions about their health plan.
- Patient education decreases polypharmacy with knowledge of medications
- It decreases medication errors and adverse drug events.
- Patients’ understanding of medications and plans of care may increase compliance.
- Patient perceive an active role in their health care leads to increased satisfaction and improved quality of life.
- Medication Reconciliation
Another important area of polypharmacy is medicines reconciliation to ensure that when patients are discharged from the hospital, especially after an acute admission, systems exist for rapid communication of changed medications to primary care teams. Maintaining these primary records makes it easy to consult with secondary care. Hence reduces the chance of over-prescription and medication.
Conclusion
Medications or overmedication is a big challenge for older adults, and preventing these errors needs a collaborative approach in every sector of healthcare. Regular medication review, clear communication with providers, patient education, visitors keeping an updated medication list, technologies in healthcare, etc. The job to improve today starts with medication safety, while one may be saving lives, and protecting the future health of older adults.
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