Polypharmacy: What Is It and What Can Working Caregivers Do About it? (Blog 1/14/25)

Have you ever been sitting at your work desk or in a meeting and suddenly your mind flashed to a vision of your elderly parents’ pill boxes? Then your head was consumed by thoughts around managing your parents’ medications. Whether there were any prescriptions that you needed to have refilled. Were there any medications that had expired and needed to be renewed by the doctor? You remember that you had been wanting to speak with your parents’ doctors regarding  their extensive lists of medications to get a better understanding of what each one does and how they interact with each other. Do the primary care doctors know what medications are being prescribed by the specialist doctors and vice versa?  Have you ever found yourself overwhelmed with similar thoughts and wondering when you would find the time to carry out these critical tasks? Have you then realized that you lost productive time? Not paying attention in your meeting or being able to focus on your work.

The topic of this blog is very important and is something that occurs quite frequently when caring for aging individuals. It’s called “polypharmacy?” If you are a caregiver or a care recipient this is a word that you may want to become familiar with. Simply stated the word polypharmacy refers to using five or more prescription drugs simultaneously to treat diseases or health conditions. (Center for Disease Control “CDC”) According to the CDC at least one-third of Americans between the ages of 60 and 70 use five or more prescription drugs on a regular basis. In this blog, we discuss risks associated with polypharmacy and what you as a caregiver or care recipient can do to help reduce or eliminate these risks to better ensure that your caregiver journey is as safe and healthy as possible.

The Risks Associated with Polypharmacy

“Medicines are meant to help, not harm. But sometimes taking too many drugs can be dangerous, especially for older adults.” This statement made in an article by the National Institute on Aging (“NIA”) goes to the core of the problem. According to the NIA, polypharmacy is more likely to be experienced by senior citizens because that population is more often dealing with multiple diseases simultaneously such as high cholesterol, high blood pressure, arthritis and diabetes, just to name a few. However, daily consumption of multiple medications increases the risks of adverse reactions including: cognitive impairment, drowsiness, falls, harmful drug interactions, worsening of the condition or triggering new ones. 

Whether you are a caregiver or a care recipient, perhaps you have noticed or experienced (respectively) some of these side effects of overmedication. For example, caregivers, have you noticed that your loved one dozes off frequently while watching T.V., reading or during other daily activities? Care recipients, do you often feel dizzy or light-headed without warning? These may be signs of overmedication. We want to be sure to point out here that the best way to make that determination is to have a conversation with your doctor. In fact, some medications can be even more harmful if stopped abruptly and should be accomplished only under the doctor’s supervision. This leads us into the next topic for discussion regarding polypharmacy management and solutions.

What You Can Do to Help Manage Polypharmacy 

Much of the research in this area points to deprescribing as an important strategy in helping to manage issues around overmedication of aging individuals. This involves meeting with the doctor to review your list of medications, telling them about any adverse symptoms and asking them if there are any of the medications that are no longer needed or that can be reduced in dosage. Surprisingly, research indicates it is not uncommon to find patients still taking medications long after a particular condition has improved or stopped altogether. 

That’s why if you are a caregiver it is important for you to become familiar with all of your loved one’s medication, its purpose and potential side effects. If your loved one is unable to advocate for themselves, they will need you to advocate with the doctor on their behalf. You should update the doctor regarding any side effects that you are aware of and how their medication can be altered to improve their quality of life. 

The literature on this topic recommends conducting at least an annual review of medications being taken to reduce or even eliminate the risks of negative consequences resulting from  polypharmacy. 

Conclusion

The CDC refers to adverse drug events as “a large public health problem,” noting that individuals 65+ years of age visit emergency rooms about 450,000 times a year, which is over double the visits of younger individuals. Further, older individuals are almost seven times more likely to be hospitalized following an E.R. visit than their younger counterparts. Overall, adverse drug events contribute to 1.3 million E.R. visits annually. These numbers are significant, to say the least. 

Caregivers, you can play a critical role in helping to minimize potential adverse drug events by learning and understanding the complete list of drugs your loved one has been prescribed, paying careful attention to identify any side effects, discussing side effects with your loved one (where possible) and conducting periodic meetings with the doctor to discuss any issues and needed prescription changes. Taking these steps can go a long way in helping to improve your loved one’s health and quality of life. We leave you with the following questions:

Working Caregivers:

• Do you know how many medications your care recipient takes daily and how they interact with each other?

• Do you meet with the doctor periodically (at least once a year) to review the prescription list and discuss any potential issues or changes needed?

Employers/Leaders/HR: 

• Do you think your employees would benefit from a speaker coming to your workplace to help educate them on this topic? Contact us to find out how.  

If you want to learn more about medication use in the elderly and better medication management, here are a couple of great expert resources to check out:

https://www.geriatrx.org/post/first-amazing-podcast  GeriatRx is a pharmacist based consulting service for all adult populations with a specific interest in the well-being and quality management of elderly patients founded by Dr. DeLon Canterbury.  Dr. Canterbury is a Board Certified Geriatric Pharmacist who focuses on the special needs of older patients who may have concurrent illnesses taking multiple medications.  

https://donnabartlett.com/category/podcasts/  Wise & Well was founded by Dr. Donna Bartlett and her goal is to empower patients, healthcare providers, healthcare agents, and the healthcare system to take an active role to Deprescribing and Optimize medications. Dr. Bartlett is a Board-Certified Geriatric Pharmacist (BCGP) licensed in Massachusetts.  She is author of the book “ MedStrong: Shed Your Meds for a Better, Healthier You”.

Until the next blog!

Thank you for stopping by, reading, and for caring!

References

• Center for Disease Control and Prevention, Adverse Drug Events in Adults, Last reviewed: April 6, 2023.

• National Institute on Aging, The dangers of polypharmacy and the case for deprescribing in older adults, August 21, 2021.