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Helping with medication – avoiding polypharmacy

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Summary

As a Carent helping your ageing parent with their medication, one of the key things to consider and check up on is polypharmacy in the elderly. Does your parent still need all of the medicines which are being prescribed and issued to them?

Too much unnecessary medicine can be dangerous and regular checks can help to prune lengthy prescriptions and assist with medicines management.

What is Polypharmacy?

If you are caring for an older relative, there is a high chance that they are taking a lot of different medicines and that you might need to help them organise their prescriptions.

As more people live longer with multiple long-term health conditions, the number of medicines they take often increases. This situation – which experts call polypharmacy –  can create a significant burden for individuals and in some cases it can increase the risks of medicine related harm.

The World Health Organisation has identified polypharmacy in the elderly as an area where early action and effective management could help to keep your loved ones safe and well..

Across the UK, over one third of adults aged over 75 years of age take four or more medicines regularly and this rises to eight per day for adults in a nursing home.

As a Carent helping your ageing parent with their medication, one of the key things to consider and check up on, is whether they still actually need all of the medicines which are being prescribed and issued for them.

What are the Symptoms of Polypharmacy?

Simply put – the more medicines, the greater the risks of them becoming harmful.  Polypharmacy compounds any risks of medicine related harm because it increases the probability of experiencing unpleasant or potentially dangerous side effects particularly those related to a risky cocktail of drugs.

The risks of taking too many medicines are wide ranging and can be serious. For example, people who take multiple different medicines are more likely to be admitted to hospital as an emergency and more likely to need long term residential care.

Often, the symptoms of polypharmacy are non-specific and can be mistaken for ageing.  Typically, they include tiredness, sleepiness, constipation, diarrhoea, incontinence, loss of appetite, confusion, depression, weakness, tremors, anxiety, and dizziness. These symptoms can make everyday life more unpleasant than necessary.

More importantly, and especially in older adults,  these apparently minor symptoms can lead to serious consequences by increasing the risk of falls, fractures and head injuries.

Polypharmacy has a tendency to spiral over time as more drugs are prescribed to treat existing side effects or when side effects are thought to be signs of new illnesses. Often people can be prescribed the same medicine for many years even if it is no longer needed and simply because no one has actually thought to stop it.

What are the Symptoms of Polypharmacy?

Simply put – the more medicines, the greater the risks of them becoming harmful.  Polypharmacy compounds any risks of medicine related harm because it increases the probability of experiencing unpleasant or potentially dangerous side effects particularly those related to a risky cocktail of drugs.

The risks of taking too many medicines are wide ranging and can be serious. For example, people who take multiple different medicines are more likely to be admitted to hospital as an emergency and more likely to need long term residential care.

Often, the symptoms of polypharmacy are non-specific and can be mistaken for ageing.  Typically, they include tiredness, sleepiness, constipation, diarrhoea, incontinence, loss of appetite, confusion, depression, weakness, tremors, anxiety, and dizziness. These symptoms can make everyday life more unpleasant than necessary.

More importantly, and especially in older adults,  these apparently minor symptoms can lead to serious consequences by increasing the risk of falls, fractures and head injuries.

Polypharmacy has a tendency to spiral over time as more drugs are prescribed to treat existing side effects or when side effects are thought to be signs of new illnesses. Often people can be prescribed the same medicine for many years even if it is no longer needed and simply because no one has actually thought to stop it.

Harmful Prescribing

Studies show that over 50% of older people are prescribed a medicine with more harm than benefit, leading to preventable suffering and the need for urgent hospital care.

What can you do?

You can support someone to manage their medicine and check whether they are at risk from:

    • Overprescribing

    • Interactions between different medicines

    • Avoidable side effects

In practice, this means ensuring appropriate discussions with their clinical team at the hospital or GP surgery or with the pharmacist who issues their medicines.

Regular medication reviews

To minimise the dangers of polypharmacy in older adults, experts recommend that every medication regime should be reviewed monthly.  This process is usually done by the prescribing doctor or pharmacist and should focus on identifying and stopping any unnecessary medicines, and ensuring all existing medicines are prescribed in the safest form, and at the safest dose and frequency.

Questions to ask a doctor or pharmacist about each prescribed medicine: 

– What is the medicine for? 
– How and when do I take it and how long for? 
– Are there any side effects? 
– What should I do if I become ill while taking this medicine? 
– Do I still need this medicine?
– Can any of my medicines be stopped?

When was your parent last involved in a medication review? Is it time for another?

Join the conversation 

You can read  more about the dangers of overprescribing and polypharmacy at the Me & My Medicines website with some related videos and animations at this Vimeo link.

Twitter also has a lively debate on this topic @me+mymedicine and @stevechemist.

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Published August 2023

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