Over the past three decades, there has been an explosion in prescription medications available to treat different health conditions. This is a positive development, especially with regard to the ability to manage depression, diabetes, and heart disease. But there is a downside.
Elderly patients on multiple medications are often walking a tightrope with respect to the stability of their health. Failure to take medications as a doctor prescribes, due to neglect, forgetfulness, or inability to afford medication, can lead to a worsening of medical conditions.
Even when medications are taken exactly as a doctor prescribes, unforeseen changes in your general health can weaken the body's ability to process and eliminate medications, leading to a potentially toxic buildup of what was previously a helpful drug.
Your kidneys and liver may function less well as you age, which can lead to high drug levels and a cascade of negative health consequences, possibly culminating in hospitalization, or worse.
Taking prescribed medication is not a threat to your health. Your doctor has prescribed the medications you now take because the risk of not taking these medications is greater than the risk of taking them.
However, it is important to work closely with your doctor and pharmacist to manage your list of medications, taking into account physical changes that may occur.
“If you are taking more than five prescription medications on a regular basis, is vitally important to schedule three or four periodic visits with your physician per year to review and update the medication list and give your physician a chance to reevaluate your general health status with your medications in mind,” says Dr. Lawren Hicks, MD, medical director for Senior Services at John Muir Health.
When you visit your doctor, the pharmacy, or the hospital, bring your medications in their bottles with you so you can go over them in detail. With the pills and bottles in front of you, there is much less chance of miscommunication with respect to drugs, dosages, and any changes your doctor recommends.
“Anytime a new medication is prescribed, it is important that the prescriber be aware of all your other medications, in order to lessen the possibility of adverse drug interactions,” says Hicks.
One of the greatest opportunities for drug errors happens when you are admitted or discharged from the hospital.
On admission and discharge, hospital staff may not be aware of every single medication you take, particularly if you are very ill and not able to coherently speak for yourself, and if your family does is not familiar with your medications.
It is very important that you and your family have an opportunity to reconcile your old home medication list with the hospital, and then with a follow-up visit from a home care nurse or with your primary care physician.
“Medication errors are a well-known cause of hospital readmissions shortly after discharge,” Hicks points out. “Medical professionals are not infallible, and the longer your medication list is, the greater the chance for error.”
If you are taking five or more regular medications and you start to feel sick, there is a possibility that less medication is better than more. This is another good opportunity to review your medication list with your doctor.
“You can inquire whether all the medications on your list are still necessary, whether or not dosages might be reduced, or whether there are equivalent medications that are less expensive or could be taken less frequently per day,” suggests Hicks.
It is very important to keep an updated list of all your medications, pill dosages, and how often you need to take them in your wallet at all times. You can produce this if you see someone other than your personal physician. It is also handy if you have to give information out about your medications.