Understanding the Complex Medication Management of Seniors

The Dangers of Polypharmacy
The term “polypharmacy” means “many drugs” and refers to problems that can occur when a patient is taking more medications than are actually needed. As you know, this is of particular concern for older adults. Many of your senior patients:

• Take 5 or more prescription medications
• Take medications more than once a day
• See more than one physician
• Fill prescriptions at more than one pharmacy

Older adults routinely take one or more prescription drugs, plus several over-the-counter or supplemental remedies, on a daily basis. They may be taking medications they don’t need and, because they may take medications without informing their physicians, they may be unaware they are at risk for unwelcome drug interactions.

In addition, your senior patients may take the wrong dose of medication, take their medicines improperly, or forget to take their medicines entirely.

Community resources, such as county or home health nurses, can help seniors manage their medications safely. These at-home nurses can assist with medication setup and help patients monitor their medication plans.

The Patient-Provider Partnership

Nothing is more helpful than empowering your patients to help manage their own medication challenges. Along these lines, you can:

• Encourage your patients to ask questions
• Suggest that your patients meet with their pharmacist before taking any new medication
• Encourage your patients to fill their prescriptions at the same pharmacy
• Include and educate both the patients and their caregivers

Common Drug Interactions
Adverse drug interactions can occur between:

• Antacids and many prescription drugs

• Antihistamines and:
– high blood pressure medications
– medication for depression

• Nasal decongestants and patients with:
– heart disease
– high blood pressure
– thyroid disease
– diabetes
– urination difficulty due to enlarged prostate gland

Managing Polypharmacy: A Team Effort
One vital step to managing polypharmacy is to educate your patients and their caregivers. Ask them to inform you of all their additional health practitioners and the medicines these practitioners have prescribed. Often, your senior patients will not think to do this without prompting.

Another key step is to make a list of all medications (including over-the-counter drugs, herbal supplements, and medications applied topically such as creams and lotions) that your patient is currently using. With a full record ofmedications your patient is taking, you will be able to assess risks and avoid possible interactions before they occur.

Provided as an educational resource by Merck