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Overmedicating Seniors: Fifty percent of seniors are taking too many medications.

From high blood pressure to high cholesterol, mental health issues and chronic pain--getting older can mean taking several daily medications to manage ongoing health issues. Some of those medications may be prescribed by a primary care physician; others may be through a specialist. If you go to the hospital, you may get more meds upon discharge. Combine them all and it's easy to see how you can be taking a lot of medications.

"Polypharmacy is the medical term used to describe the simultaneous use of multiple medications for one or more conditions and can often result in negative outcomes," explains clinical pharmacist Dominick A. Bailey, PharmD, Division of Geriatrics at UCLA Medical Center. "We mostly use medications to heal ailments in Western medicine. But, you can be on one medication to treat a condition and another to treat the side effect of that medication without knowing."

But more isn't necessarily better, especially in older adults.

Addition and Subtraction

Taking too many medications can lead to increased risk of falls, more urinary tract infections, poor nutrition, and dangerous drug interactions. Studies show that adverse drug interactions are a frequent cause of preventable emergency room visits and hospitalizations.

Because of the fragmented way in which our healthcare system operates, a patient's medications and treatment history aren't customarily summarized on one cohesive medical record. That, however, is starting to change. As an inpatient clinical pharmacist specializing in geriatrics, Dr. Bailey serves a crucial role in medicine--he assesses the totality of a patient's medications.

"With geriatric patients, you want to think about subtracting medications because age-related physiological changes result in greater sensitivity to medications," he explains. "Because of that sensitivity, when you add more medicine you're going to get different effects than you might in younger patients. That's why we look at medication deletion and try to maximize what patients are already taking."

That might mean changing the dose or frequency of a current medication rather than adding another. To determine the best course of action, your current medications and health status need careful review.

Medication Therapy Management

If you're enrolled in a Medicare drug plan and take multiple medications for different medical conditions, you may be eligible to get services, at no cost to you, through a Medication Therapy Management (MTM) program. This valuable resource may also be covered by some insurance policies and may require a referral from your primary care physician. It's a good idea to have this review before an annual wellness visit.

MTM is typically an appointment with a pharmacist and lasts about an hour. Topics covered include:

* How well your medications are working

* Whether your medications have side effects

* If there might be interactions between the drugs you're taking

* Cost-lowering opportunities.

Patients should receive a written summary of the discussion and an action plan that recommends how to make the best use of medications. A personal medication list that describes the purpose of medications should also be included.

If the pharmacist recommends a change in medication, the primary care provider or any specialist involved will need to approve the change.

The UCLA MTM program is called My Meds and includes one-on-one consultations with a clinical pharmacist. My Meds pharmacists document the session, which becomes part of a patient's medical record.

Your Role in Medication Management

Even if you're not taking a lot of medications, it's wise to be literate about what you're taking and why. A "brown bag" consultation refers to a session that can be conducted by participating pharmacists, your primary care physician or a specialist who prescribes your medications. Take all your medications, over-the-counter drugs (e.g., aspirin, Ibuprofen, acetaminophen), vitamins, herbs, and any other supplements. Your pharmacist can supply you with a list of prescriptions filled.

Using one pharmacy for all your prescriptions provides an avenue for organizing medications and more. "Community pharmacists can make very timely interventions, such as recognizing and correcting gaps in filling patterns and monitoring for medication interactions based on your filling history," says Bailey.

If you experience new symptoms from recent or existing medications, such as loss of appetite, dizziness, or fatigue, tell your healthcare provider. And before you add or subtract any medications, talk to your physician first.
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Publication:Healthy Years
Date:Jan 1, 2018
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