Less may be More...

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 

Author
Andrea G. Espinoza MD Board Certified Pulmonologist Board Certified LifeStyle Medicine

You Might Also Enjoy...

What is the best exercise for…?

Physical Therapists carefully assess each individual patient to carefully determine what exercises and treatment options will help them recover.

OCSM: Physical Therapy

If you experience a personal injury or undergo surgery, physical therapy can speed up your recovery process, restoring strength and mobility. The caring team at the Orthopedic Center for Sports Medicine in Metairie, offer several types of therapy options.

Peroneal tendon tears of the ankle

Behind the bony prominence of the outer ankle, there are 2 tendons: the peroneus brevis and longus. These assist with the eversion and flexion of the foot and are commonly injured. Treatment will depend on the grade of the tear and clinical presentation.

What is Asthma?

Asthma is a common disease affecting your lungs and breathing. It’s one of the most common chronic conditions in children, but you can have it as an adult too. Once diagnosed, asthma can be treated to minimize the frequency and severity of the attacks.

Fifth Metacarpal Fracture

Fifth metacarpal fractures or "street fighter's boxer" fractures are traumatic injuries, most commonly acquired during altercations, that result in the fracture of the fifth metatarsal bone.

Viscosupplementation for osteoarthritis

Viscosupplementation is a procedure done in the office where a thick fluid called hyaluronate is injected into the joint space, usually the knee. It is thought that injecting hyaluronate will improve the lubricating properties of the synovial fluid.