Polypharmacy is one of the main problems that older adults in the community face. In simple terms, polypharmacy means using more than five medications at a given time.
These medications can range from simple allergy medications, inhalers and antibiotics to complex medications taken for heart disease, kidney disease and lung disease.
Older adults living in the community, at any given time, typically take more than five medications of “over the counter medications” and “telehealth prescriptions.” However, it is important to determine if they are medically necessary after a certain point.
I always tell my patients that my goal for the older adult is to keep them on as few medications as clinically indicated. I decided to follow this rule in my practice because most of the older adult patients I see have been on chronic medications for a long time without even realizing they don’t need to be on them anymore.
Simple examples include medications for heartburn, which when taken for longer times than clinically indicated can lead to osteoporosis or weakening of bones leading to fragility fractures.
They also include aspirin, which was previously indicated for primary prevention of heart disease but is no longer recommended for older adults to take, unless they have a previous history of a stroke or myocardial infarction.
Polypharmacy can also lead to drug interactions or adverse drug reactions because some medications interact with each other and could lead to potential toxicity. The difficult part is that it takes a long time for these adverse reactions to show up symptomatically, and by that time the body would have already taken a hit.
Others in the community that get affected by polypharmacy are nursing home residents. Often they are started on medications by providers and are kept on them for a long time. We have to be more vigilant when it comes to taking medications chronically and ask providers the clinical reasoning behind taking every medication.
Please be mindful of the medications you take, and if you have a question or a concern, never hesitate to ask your provider.
Anyone who would like to ask me a medical question relating to the health of older adults can email me at questions@apexmedicalgroup.org. I hope to provide a helpful answer in a future issue of this newspaper. Thank you.
Disclaimer : The information shared in this column is based on current practice guidelines but is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your healthcare provider with any questions regarding a medical condition.
Dr. Arvind Selvan is a physician board certified in internal medicine, with a subspecialty in geriatrics. He currently works at Apex Medical Group as a primary care and geriatric medicine provider.
