Polypharmacy an increasing problem for older Americans

Polypharmacy, loosely defined as the act of taking five or more medications or supplements at once, has become more common in the U.S. as the population ages.

More than a third of older adults take at least five different prescription medications, while nearly two-thirds take some form of a dietary supplement, according to a new study from JAMA Internal Medicine.

Nearly 50% of elderly patients take one or more unnecessary medications, according to a 2013 opinion piece in the Expert Opinion on Drug Safety journal. The journal also reported that polypharmacy in older adults is associated with poorer clinical outcomes, an increased risk of falls and reduced cognitive functioning.

One major danger of polypharmacy is that patients often take over-the-counter medications and supplements without telling their physician, and these can dangerously interact with the medications they are prescribed.

Dima Qato, MD, the lead author of the JAMA Internal Medicine article, shared with the New York Times the story of a medication review she conducted with a 67-year-old man who was taking both the cholesterol drug simvastatin, or Zocor, and the blood pressure medication amlodipine, or Norvasc. Because Norvasc increases the risk of muscle pain and weakness associated with taking Zocor, a different blood pressure medication would have been a better choice for the patient.

She also learned that the patient was taking garlic and omega-3 supplements, which can have negative consequences when taken with certain prescription medications.

“Did you tell your doctor you were on them?’” Dr. Qato was quoted as asking the patient. “He said, ‘No, why should I? If it was important, why didn’t he ask me?’ ”

Health care professionals can fight polypharmacy by:

• Always asking patients to list all medications they are taking at every visit, along with all the supplements and over-the-counter drugs they take.
• For patients who take many medications and supplements, ask them to bring in all of their medication and supplement bottles for a “brown bag review,” which is when a health care professional looks through all the pills a patient is taking to make sure the patient’s not taking any unnecessary or potentially harmful medications and that the patient is taking the correct dose of all their medications. Medicare covers comprehensive medication reviews for certain patients.

Read more about polypharmacy in the New York Times.