HealthTuesday, September 11, 2007 10:26 AM CDT

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Communication, common sense
can solve polypharmacy

By Dave Wegman

Polypharmacy means “many drugs” and refers to problems that can occur when patients take a large number of medications.

It is of particular concern for the elderly. They make up about 13 percent of the population but use about 30 percent of prescription drugs. The elderly often experience multiple diseases that require multiple medications, increasing the chances of adverse reactions, drug interactions and self-medication errors.

More medication side effects can result in more polypharmacy, because many medications are given to mitigate the side effects of other medications.

Polypharmacy is becoming responsible for more and more health care problems and expenses. With an increasing population of older people experiencing more health problems and consuming more prescription and non-prescription drugs, the potential exists for the cure to be worse than the cause. Adverse drug effects are the fourth leading cause of death in the United States.

The costs associated with drug-related problems are staggering. A study done in 2001 found that costs associated with drug-related problems in the U.S. exceeded $177 billion – more than the costs of the drugs themselves. Another study found that for people over 65 in the U.S., more than 25 percent of hospitalizations are medication-related, and 60 percent of those are because of adverse drug reactions or unsafe drug combinations.

Patients and their health care providers can contribute to polypharmacy. Patients often imply to their physicians that a prescription is expected when they are seen for any condition. They also frequently do not tell the physician all the medications they are taking, especially over-the-counter medications or herbal products that may interact with prescription medications. This may result in duplicate prescriptions or treating the effects of one drug by prescribing another. The more appropriate action may be to eliminate the offending medication. Visiting multiple physicians and multiple pharmacies also increases the chances for polypharmacy by reducing the ability to track other medications.

You may be at risk for polypharmacy if you are 65 years of age or older; have multiple medical conditions and take medicine more than once daily; use herbals, vitamins or other over-the-counter products in addition to prescription medications; use different pharmacies to fill your prescriptions; are being treated by multiple physicians; have poor eyesight or hearing; live alone; and sometimes forget to take medications.

Fortunately, several simple steps may be taken to reduce the odds of problems with polypharmacy:

Effective communication with your pharmacist and physician is the first step. Learn as much as you can about each medication you take, including over-the-counters and herbals as well as prescription drugs. Know what they are prescribed for and what possible side effects you may experience.

Avoid combination products by asking your pharmacist to help you find a product just for the symptoms you are experiencing.

Make a list of all medications you take and update it after each physician visit.

Be sure your physician and pharmacist know all the medications you take, and periodically discuss with your physician whether each medication you are taking is still needed.

Use only one pharmacy.

If you use more than one physician, make sure each one knows what the others have prescribed.

Read all information on medication labels.

Have a system to remind you which medications are to be taken at different times throughout each day.

Dave Wegman is pharmacy manager for Heritage Enterprises and a member of the Advisory Board for the Expanding Teaching Nursing Home Project.

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