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Too many medications can cause problems




It’s referred to in some medical circles as polypharmacy. Or it may be referred to as medication overload. Whatever term is used, the result can be deadly.

Each year thousands of patients end up in the hospital as a result of drug side effects. Naturally, the greater number of drugs being used by a person, the greater their risk.

According to WebMD, thousands of patients will die of complications of drug side effects each year. Unfortunately, the fact that more people are being prescribed more drugs than ever is adding to the risk.

Physicians are becoming more aware of this issue but have a difficult time trying to successfully address it. It is a complicated problem.

In a recent publication by Duke University Medical Center called DukeHealth, geriatric medicine specialist Milta O. Little, DO is quoted: “We have a lot of evidence for disease-specific management, but we don’t have guidelines on prescribing for people with multiple diseases who require multiple medications that have a potential for interacting with each other or with a patient’s other conditions. It has become a serious clinical issue that must be addressed and is leading to a whole new field of deprescribing strategies.”

There is a process that physicians proceed with when addressing patients that are overmedicated known as deprescribing. This can be a complex but beneficial process for patients. However, it can be tedious and time-consuming. For some physicians, the process of discontinuing a prescription can be more involved and complicated than providing the original prescription was.

Knowing, however, that too many medications can cause serious problems such as increased risk of falls and fractures, decreased mental acuity, create or worsen gastrointestinal problems, damage organs such as liver or kidneys, increase risk of cardiovascular issues and many other problems, most clinicians are willing to have a conversation with their patients about the need to continue medications.

Here are some suggestions for people that think they may be taking too many prescriptions:

• Schedule a visit to your doctor or provider specifically to discuss the concern about taking too many drugs and to ask if any can be safely discontinued. Don’t plan on throwing this question out on the same visit where the plan is to check your blood pressure or take a blood or urine sample. This conversation should be a separate event.

• Prepare a detailed list of everything you are taking by mouth, smoking or vaping, injecting or using topically (on your skin). Everything. ALL prescriptions, ALL non-prescription (over the counter) drugs, ALL vitamins and nutritional supplements, ALL herbal remedies, ANYTHING you take that could have a medicinal effect. Take your time and carefully hand write or type the list. Indicate by each product who recommended or prescribed it and what it is for. Your primary care provider may not be aware that another provider started a new prescription or changed an existing one.

• Discuss with your doctor any specific side effects that you are having. Take some time ahead of the appointment to carefully write down everything about the symptoms. Describe the symptoms, the timing, how you address the symptom for relief, etc.

• Expect to require more than one visit to accomplish the best plan for your medications. Your doctor may need to gather information, discuss your care with other providers etc.

• Be open minded. In many cases the doctor will be aware of factors that indicate the need for the medication that you may not be aware of.

• Consider consulting about this issue with other specialists that you see. That does not mean there is anything wrong with your primary care provider. Doctors have their own perspective on certain drugs or conditions that may conflict with other providers.

• Consider setting up an appointment with your pharmacist to discuss this issue. Pharmacists can often be a helpful resource in learning more about your medications, potential risks and side effects and possible interactions that could occur with other medications.

• Realize that the objective is to end up with the best plan going forward and it may be recommended to discontinue or modify some current prescriptions.

This could be a tremendously beneficial medical visit for many readers. Polypharmacy or medication overload is becoming a much more serious problem for many patients, especially those over the age of fifty.

Dr. Mark Kestner is a licensed chiropractic physician and acupuncturist with 30-plus years of experience focused primarily on treating complex and chronic spine, joint and neurological conditions in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.

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