Polypharmacy, by definition, is the use of 5 or more medications daily by an individual chronically.
These can be either prescription OR over the counter medications.
In many countries, polypharmacy rates are on the rise.
The prevalence here in the Unites States is estimated to be between 40-45%!!
The older the patient population (>65 years of age), the greater the prevalence.
Most patients I see, when reviewing medication lists with them report:
1. Being overwelmed with the number of pills they take
2. Being financially concerned with the rising cost of medications (especially Medicare patients who find themselves in "the donut hole")
3. Being unprepared or unaware of the side effects or interactions of certain medications with other drugs, food or alcohol
4. Feeling less healthy while taking "more and more medications"
5. Presenting to Urgent Care or Emergency Rooms due to a medication related event (falls, over sedation, GI issues of constipation or dehydration, dry mouth, cognitive issues)
In fact, many reports have associated polypharmacy with:
DECREASED Quality of Life
DECREASE in physical mobility
DECREASE in cognition
One of the underlying threads in this trend of polypharmacy may actually be FEAR.
As providers, we are inclined and committed to follow guidelines.
We FEAR not prescribing something that the protocols deem necessary.
Patients FEAR being labeled as "non-compliant" or "non-adherent" to care plans.
There is a sense of shame if the patient has not taken all the prescribed medications.
The "handful of meds" taken once, twice or more each day takes its toll on ALL of us.
I encourage you to have a discussion with your providers regarding:
1. "Deprescribing" therapies-ESPECIALLY if you have made lifestyle changes that no longer warrant the medication.
2. Encourage communication between specialties to avoid over prescribing or duplication of therapy
3. Review ALL prescription AND over the counter medication lists at each clinic visit with your healthcare team and make notations of "what pill is for what"
Most importantly, be honest with family and caregivers when you feel concerned about how you feel taking a certain medication. Your best medicine is your intuition and shared knowledge.
YOU are the MOST IMPORTANT member on your team. YOUR voice counts!
We remind you to AVOID suddenly stopping ANY prescribed medication without the guidance of your healthcare team.
Also, remember that FOOD, MOVEMENT, SLEEP, SOCIAL CONNECTION and NATURE can often be the most powerful medication!!
Get out, find your PURPOSE and talk to your provider TODAY about Polypharmacy.
Andrea Girod Espinoza, MD, FCCP
Board Certified Pulmonary Medicine
Certified, Lifestyle Medicine
