Polypharmacy, the managing of multiple medications, is a fact of life for most older Americans. The National Institute on Aging reports that adults age 65 and over take more medications than any other age group. But the very medications prescribed to manage cholesterol, diabetes, high blood pressure, and other health issues can cause new problems.
Excessive or nonessential prescription medications increase a person’s risk of dangerous drug interactions, cognitive impairment (a risk factor for falls, even in healthy older adults), and drug-disease interactions where the medication for one condition negatively impacts a second condition. Polypharmacy is further complicated when prescriptions from multiple health care professionals are filled at various pharmacies with differing protocols for educating patients. Further, emergency room decision-making does not always include full knowledge of a patient’s polypharmacy.
An Unfair Burden on Patients and their Families
Multiple chronic conditions are common among older adults, and managing multiple prescriptions is often the daily responsibility of the patient or their family members. Avoiding mistakes like missing a dose or taking a dose twice can be a challenge. Spacing doses correctly day and night and noting any changes in the efficacy of prescriptions is not all that’s involved.
Patients and their families also need to be on the lookout for possible allergic reactions and interactions with over-the-counter medicines, vitamins, supplements, and foods. And there are additional distractions that come with managing refills, generic and brand name options, medication affordability, and passing on all relevant instructions to hired home caregivers. When a patient has Alzheimer’s or similar dementia, there is an even greater risk that mismanaged polypharmacy will result in adverse effects and mortality.
Even when catastrophic errors are avoided, there are countless cases of lengthy hospitalizations and increased costs for care. Additionally, polypharmacy errors are frequently diagnosed as other health conditions, and that leads to unnecessary treatments.
Healthcare Professionals Trying to Improve Outcomes
A growing awareness of the risks of failed polypharmacy management is leading to research to improve patient outcomes. Areas identified for improvement within existing health care systems include:
- Uneven communication between healthcare professionals. A patient may discuss medications at length with nursing staff though the nursing staff has little involvement in medication decisions.
- Older patients are unaware of all the medications they take, and they are unaware of whether a doctor sees a complete and updated medication list when making decisions.
- Time constraints during patient admission intervals and a high volume of patients reduce the time available for discussions with patients about their medications.
- Technology lends itself to screens, not printouts, reducing the opportunities for patients to notice missing or incorrect prescription information in their records.Â
Minimizing Older Patients’ Risk from Polypharmacy
Understanding the issues of polypharmacy is the first step:
- Recognizing the key moments (from intake assessments to prescribing medications to receiving medications from pharmacies) when healthcare systems are more prone to making an error
- Making every effort to confirm that the prescription information healthcare professionals evaluate is comprehensive and current
- Appreciating the additional risks that come when a diagnosis related to dementia is involved
- Reducing the number of different providers and pharmacies involved when possible
- Documenting everything related to multiple prescriptions and following up when concerns arise or outcomes seem poor or problematic
If you believe your elderly loved one has been the victim of polypharmacy misuse, you may need to take steps to get more involved. In order to do so, a doctor or medical facility will likely ask to see a current healthcare power of attorney and signed HIPAA directive. We can help you legally complete both documents so that you can manage your loved one’s care with ease. Simply contact our Brandon elder law firm at (818) 438-8503 to get started.