Understanding Polypharmacy: The Risks and How to Manage It

Polypharmacy refers to the simultaneous use of multiple medications, specifically five or more medications daily. These medications can include prescribed drugs, over-the-counter medications, or supplements necessary for managing chronic health conditions or multiple chronic conditions.

The elderly population, with their multiple chronic conditions, is the primary demographic affected by polypharmacy. Managing several medications daily can be overwhelming, especially for older adults. In many instances, inappropriate polypharmacy can be addressed through effective communication between health professionals. However, if you or a loved one is experiencing excessive polypharmacy, it's important to educate yourself about what it entails and the steps you can take to avoid adverse drug events.

Understanding Polypharmacy: Managing Multiple Medications

While according to the World Health Organization, the scientific community does not have a universal definition for polypharmacy, it generally involves the use of multiple medications, often prescribed by different providers, for multiple chronic conditions. The term is typically used for individuals who take at least five different medications daily, with some medications taken two or three times daily.

In some cases, these medications may not be directly necessary for treating a medical condition but may help alleviate symptoms. Moreover, different doctors may prescribe several medications for the same symptoms, not realizing the patient is already being treated. This can lead to potentially inappropriate medication use and increased risk of adverse effects.

In 2018, 39% of seniors were involved in polypharmacy. As one's age increases, they become more susceptible to polypharmacy due to an increased risk of various health conditions, such as heart disease, high blood pressure, and other chronic issues requiring medication.

Why Does Polypharmacy Occur?

Polypharmacy often occurs when patients are treated by more than one doctor for complex diseases, and there is a lack of communication between providers. Patients typically see multiple specialists for treatment of chronic conditions. Without proper communication about the patient's medical history and current medications, inappropriate prescribing can occur, leading to the use of potentially inappropriate medications, adverse drug-drug interactions or medication errors.

This oversight can happen easily without efficient record management by the providers and the patient's awareness of their regular medication regimen. Even with the advent of electronic health records and online patient portals, one wrong click or one missed email update can result in a less appropriate polypharmacy.

With as much as 12% of the U.S. population experiencing polypharmacy, it becomes the responsibility of patients to ensure they are not victims of these oversights.

The Risks Associated with Polypharmacy

Polypharmacy becomes risky when medications are poorly managed at home. Elderly patients often lay out their prescription bottles on the counter as a reminder to take them, not utilizing medication management systems. As a result, it's not uncommon for seniors to make mistakes when taking their prescriptions, leading to medication errors.

Even with a reminder note or a weekly pill case, many older patients tend to forget to take their medication, which can result in serious consequences beyond just missing a dose. In other scenarios, people may even ignore the instructions on the bottles, taking all of their medications at the same time with or without food in efforts to consolidate their routine and make the process easier.

Adverse Drug Reactions

With polypharmacy, potentially dangerous drug interactions can also go unnoticed. Such scenarios are especially likely when the provider doesn’t make enough of an effort to communicate with the patient about medications being prescribed. When this happens, medications prescribed may be treating the symptoms of the same condition, when just one prescription would have been enough.

When mixing the wrong drugs or taking too much of one medication, dangerous or even fatal side effects can occur. Some drug reactions may also cause long-term internal damage to the patient’s liver or kidneys without presenting visible symptoms, making it all the more important to be aware of the risks involved in polypharmacy.

Preventing Polypharmacy

There are several things you can do to prevent unnecessary polypharmacy and take initiative with your own health:

Recognize Signs and Reactions to Polypharmacy

Adverse drug-drug reactions often manifest as tiredness, confusion, hallucinations, dizziness, loss of appetite, and skin rashes. They may also cause anxiety, depression, or intense excitability. It can be hard to recognize these symptoms, especially if they onset gradually, but keeping a journal about what medications you take when and how you feel over the next few hours after a dose may reveal helpful information about possible interactions.

The signs of a prescription overdose are slightly different than drug-drug interactions, and can include confusion, extreme behavior changes, slurred speech, or an irregular heartbeat. If you notice extreme behavior changes, it could be possible that you are taking too much medication, or mixing medications that should not be taken together.

Seek medical advice or medical attention if any of these symptoms become severe, especially if you are just starting on a new medication for the first time.

Be Proactive About Tracking Medications

You should always make it a point to not just track what medications are being taken, but also what those medications are for, dosage instructions, and possible interactions.

Make sure all of your providers have an up to date record of these medications at all times--always bring this record with you when you go in for an appointment, even if it’s just a routine visit.

Take Initiative Toward Conscious Medication Management

Coming up with a proper medication management system is essential for preventing unnecessary polypharmacy. One of the easiest ways to do this is with the use of an automated pill dispenser.

Hero offers an automatic pill dispenser that serves as an easy to use, integrated med management system. When it’s time for medication to be taken, Hero will sort and dispense the proper dose, and alert the individual with a blinking light and a friendly chime. With the Hero app, notifications can also be sent to the patient’s and the caregiver’s device, helping to make sure that doses aren’t missed.

The Hero pill dispenser can store, sort, and dispense up to 90 day’s worth of 10 medications, and can also help you manage an additional 10 medications in the app. You can use the Hero app to program any medication schedule, and it will even notify you when it’s time for a refill.

Hero takes matters beyond pill dispensing and offers a streamlined medication management system, which can not only help increase safety when it’s time to take medication, but also provides a dependable place to store records and information about medications are being taken, what they’re being taken for, and if there may be a contraindication present that wasn’t previously apparent.

Try Hero Today

Taking multiple medications isn’t always a bad thing -- however, mismanaging these medications can put countless patients at risk.

If you are a caregiver or a patient and are worried about polypharmacy, try Hero for peace of mind. We can help you and your loved one stay on top of your medication management routine, so you’re not only on track about prescriptions, but you’re also informed about and in control of health as a whole.

Sources:

https://pubmed.ncbi.nlm.nih.gov/19552494/

https://www.freedomcareny.com/posts/what-is-polypharmacy

https://www.aafp.org/afp/2019/0701/p32.html

https://www.uspharmacist.com/article/polypharmacy

https://www.rasmussen.edu/degrees/health-sciences/blog/what-is-polypharmacy/