Polypharmacy Concerns and Risks

Taking Too Many Medications Can Negatively Affect Your Health

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Polypharmacy is the concurrent use of multiple medications. While there are almost always good intentions behind this—treating several chronic conditions at the same time, for example—it can cause side effects and even additional health concerns. Seniors, who are more likely to take many different prescriptions, are at the highest risk of adverse effects from polypharmacy. While you should never stop taking a medication because of this without your doctor's OK, you can play an active role in ensuring that you reduce any possible risks.

Effects

The advice to tell any doctor you see all of the medications and supplements you are taking, prescription or over the counter, is critical. While a drug may be recommended to you because of a specific intended purpose, drugs do not act in isolation in your system. As such, everything you are taking must be considered when making treatment choices.

Polypharmacy poses several concerns:

  • Excessive known side effects, particularly for the elderly, as sensitivities to medication increase with age
  • Additive side effects when several medications induce similar physical responses
  • Dangerous drug interactions, which may produce new side effects not typically associated with either medication
  • Diminished effectiveness of one medication due to the metabolic action another medication
  • Confusion with regard to medication use, resulting in missed doses, extra doses, or other errors

Why It Occurs

Polypharmacy is very common. Often, seniors or people with many health problems need to take several medications to control multiple medical conditions. While these medications, individually, may be warranted, there are times when the number of drugs prescribed for a given issue is more than is necessary. There are a variety of other reasons polypharmacy can occur as well, including:

  • Prescribing cascades: If you have several health conditions, you may experience what is described as a "prescribing cascade," in which you are given a prescription to counteract side effects of another medication or to counteract an interaction between two or more other prescribed medications.
  • Disconnected medical care: This is more likely to occur if you or your loved one is cared for by several doctors, including specialists or physicians who may only see you for a short period of time, such as during an urgent hospitalization. One doctor may give you a prescription that compounds or counteracts the effect of a medication you already take, particularly if you are getting care at a different healthcare center than usual.
  • Pharmacy changes: If you fill your prescriptions at multiple pharmacies, none are likely to have a complete list of your medication regimen (unless you have visited multiple locations of a pharmacy chain). Interactions between medications may go unnoticed when the combination would have raised a red flag if you were getting all of your prescriptions from the same place.

    Prevention

    Polypharmacy can be managed as a team effort between healthcare providers, patients, and families.

    What you can do (or help a loved one with):

    • Pick a point person: Be sure to select a primary care practitioner or a geriatrician who you are comfortable with and schedule regular appointments with this lead physician. Usually, when you see a physician specialist, your primary care doctor receives a consultation note, along with all new medication recommendations, from your specialist. When you see your primary care doctor, he or she should know all of your medical problems, which other doctors you see, and which medications you take. This doctor can recognize signs and symptoms of polypharmacy and can discontinue redundant or unnecessary medications if you are taking any.
    • Keep track of medications: List out all of your medications and supplements, and review it regularly for necessary updates. Bring this list to all your appointments and show it to your care providers. Ask them to check the list for any possible complications and remember to discuss all of your medical symptoms, as some might be side effects of your medications.
    • Talk to your pharmacist: Pharmacists are trained to look for drug interactions and other problems, but they can only do that if they have all your information. Hand them your prescription list and ask them to look it over. This is especially important if you get your medications from more than one pharmacy. Consultations are free.
    • Don't stop your medications without approval from your doctor. You might be prescribed more than one heart or diabetes medication because one is not enough to control your condition. While polypharmacy can be harmful, medication adherence is important too.

    Healthcare systems are continuously looking for ways to play their part. Systemic solutions include:

    • Strict recording keeping and updating: Tracking of prescriptions can allow your medical team to find your medication list more easily. This type of list may be generated within a medical clinic or hospital system, not between systems.
    • "Smart" systems that recognize and flag dangerous medication interactions and redundant prescriptions
    • Patient-friendly information describing the risks and benefits of each medication to be provided along with prescriptions

    A Word From Verywell

    Anyone can become confused and overwhelmed by medical terminology and instructions, especially when taking several medications for many health problems. If that's the case for you, keep a trusted family member or friend in the loop regarding your health care. You might even ask this person to attend doctor's appointments with you, so you can have a second set of ears for important information that may be shared—and a back-up mind to help you remember things you should mention as well.

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