Polypharmacy, defined as regular use of at least five or more medications, is common in older adults and younger at-risk populations, and increases the risk of adverse drug reactions (medication errors, bad reactions, allergic reactions and overdoses). In today’s article, Charles Hill, a Registered Pharmacist and the Director of Keystone Pharmacy, discusses how patients who are taking multiple drugs can ensure their medication safety.
How great is the risk?
In a study from the American Journal of Emergency Medicine, the risk of adverse events goes from 13% when taking two medications, to 58% when taking five drugs. When you start taking seven or more medications, the risk surpasses 80%. The risk increases by 7-10% with each medication. In addition to the increased risk of an adverse drug event, there is an increased risk of drug interactions, decline in compliance (it is hard to keep track of what drugs to take and when to take them) and of course last but never the least among concerns, is the increase in costs.
How did we get here?
There are many reasons you might end up on so many medications. Patients might have multiple medical conditions managed by multiple subspecialist physicians, or chronic mental health conditions. For example, a U.S. Pharmacist article noted that it is not unusual for patients with respiratory problems, type 2 diabetes and coronary heart disease to take six to nine medications to help reduce long-term risk of further complications or secondary heart-related events. Additionally, poorly updated medical records, automated refill services and prescribing to meet disease-specific quality metrics all pile on the drug therapy.
What can you do?
If you fill prescriptions across multiple pharmacies, I encourage to you consolidate and move all of your medications to a single pharmacy. Getting an accurate list of medications can be challenging when you’re spread out all over the community. The next step is completing a comprehensive medication review with your pharmacist. Many insurance companies will pay for this service and many pharmacies will offer it free of charge to their patients who are enrolled in their compliance programs. You can expect to spend 30 minutes or more with your pharmacist covering your prescribed medications, over-the-counter medications, herbal supplements, and more. You and your pharmacist will discuss why you’re taking the medications that you use. We find that many patients don’t know why they’re taking a certain medication. It’s ok if you are unsure. You’re not alone and your pharmacy staff is glad to help. You will be asked when you are taking your medications. Did you know some drugs work better when taken at prescribed times? Your pharmacist can help you decide which medications should be taken when. He or she can also help you reorganize your medications by condition, which in turn may help identify inappropriate and incorrect prescriptions.
How can I keep multiple medications organized?
It’s not always possible to eliminate the number of medications you take. Because the number of medications you are on can make compliance more difficult, I would encourage you to seek out a pharmacy with a medication synchronization service. Your pharmacist, a certified pharmacy technician and you will work together with your prescriber to organize your medicines into one convenient pickup (or delivery) time. If you still need help staying organized, consider the addition of blister packing. Your medications can be arranged by day and time of day by the pharmacy, so you don’t have to organize them on your own. This can save you not only time, but can protect you from potential medication errors as well.
We’re here to help, and if you have never thought about how many medications you were taking or whether or not the over-the-counter meds and supplements you are taking may interact with your prescribed medication, I encourage you to come in and talk with us.
This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.