Polypharmacy is the rather uniquely Western medicine epidemic of popping too many prescription drugs.
There’s an old healthcare joke with the punchline “There’s a drug for that!” Sadly, that’s true.
It’s ironic, but too much health care is killing us, especially our seniors. A recent report by the Lown Institute shows the scope of the problem:
- There’s been a 300% increase in polypharmacy over the last 20 years.
- 42% of older adults take 5 or more prescription medications.
- 20% of older adults take 10 or more prescription medications.
- Every day, 750 older adults are hospitalized due to serious side effects from one or more medications.
- There will be 150,000 premature deaths in next 10 years due to serious side effects.
- We will spend $62 billion in unnecessary hospitalizations over the next 10 years.
Beware the prescribing cascade
Prescriptions can pile up because of the “prescribing cascade.”
A drug causes a side effect, and another drug is prescribed to treat it, and so on…
Fatigue, insomnia, headache, upset stomach, joint or muscle pain, and depression are all common side effects of common prescription drugs. Rather than treat these conditions by stopping or changing a medication, a doctor may simply prescribe another drug, or suggest an over-the-counter product.
The elderly are vulnerable for a number of reasons. One, they have more conditions that might be best treated with a medication, such as high blood pressure, diabetes, arthritis, etc.
Two, as we age our bodies don’t process and eliminate drugs as easily. Kidneys and livers don’t work as well!
Three, seniors are of a generation that still thinks “doctor knows best” and don’t question prescriptions. (Tip: always question a new prescription, no matter your age.)
Four, increased confusion or dementia makes it too difficult for some seniors to keep an accurate medication list, and take those drugs properly.
Take charge of your medications
The World Health Organization recognizes polypharmacy as a growing health crisis and put out this public awareness video on YouTube.
I also like Dr. Mike Evans’s helpful suggestions for maintaining an up-to-date medication list. Always take it with you to a doctor’s visit—don’t rely on electronic health records!
If you can, help your elderly parents or family members keep track of their prescriptions. Ask them if they know what each drug is for. If they seem confused, offer to visit their doctor with them, and ask the doctor directly.
Many doctors, at least those that treat the elderly, are taking the polypharmacy crisis seriously and advocating cutting back or “deprescribing” drugs for their patients.
You can protect yourself from being a victim of polypharmacy, too, by getting into the habit of asking lots of questions before being prescribed a new drug. Weigh the benefits against the risks and make an informed decision.
Don’t let prescriptions pile up!
Want to know more? These are some helpful books: