Today's blog is written by SAS pharmacist, Kristin Ellison
Overall health is impacted by many variables; heredity, lifestyle habits, diet, stress, exercise, and sleep all play a role in your wellbeing. As you age, the likelihood of requiring medications to assist in your overall health increases. Taking multiple medications can be medically appropriate but taking too many can cause negative consequences. Inappropriate polypharmacy is associated with negative health outcomes and is a growing concern in the aging population. Finding the balance between taking what is medically appropriate while eliminating duplications is essential. Updating providers and the pharmacy when medications, including over the counter products, are added or discontinued is a crucial way you can help prevent polypharmacy.
What contributes to inappropriate polypharmacy?
Over the counter products are one of the biggest culprits contributing to polypharmacy for multiple reasons. Over the counter medications and herbal products, although advertised as natural, can often interact with prescription medications. They also do not have the same regulatory requirements as prescription drugs and can have serious consequences if taken inappropriately. Informing your provider and pharmacist before you start taking something new can help prevent an adverse reaction or drug interactions. Your pharmacist and provider can review your medications to ensure it is safe to start taking the new over the counter medications.
Many companies advertise their over the counter products via various outlets such as TV commercials, radio or online. These advertisements are another reason someone may decide to start taking something over the counter. Whether it is advertised to help with sleep, mood, weight or overall health, ads can be very persuading. Unfortunately, the ads can be misleading and do not take into account medications you may already be taking. For example, ZzzQuil® is advertised for sleep but the ingredient is the same as Benadryl. Many patients already take Benadryl or a similar medication (Zyrtec® or Claritin®) for allergies and adding ZzzQuil® could have negative consequences. It is important to identify which product you need so you receive the desired effect. The umbrella name Tylenol® is listed on many products. Some advertised for allergy, some for flu, cough/congestion. All the products contain a range of ingredients and it is easy to pick the one “advertised” for what you think you are treating. However, it may not be the best one for your symptoms or may duplicate something else you are already taking. Always check the list of active ingredients and consult your provider or pharmacist if you have questions.
Another contributing factor to polypharmacy is hospitalization discharge. In the event you are hospitalized, medications can be started, stopped or switched based on what is needed. Hospitalization is an overwhelming time and there is usually a plethora of discharge information. Sometimes it is not clear a medication started at the hospital is replacing something used at home. One way to help with this process is to carry an updated medication list. This helps inform the medical team of current medications if you are hospitalized. If possible, have someone with you at discharge to help take notes or remember instructions. Follow up with your provider and pharmacist after discharge with medications updates.
When you are starting or stopping medications or have a dose change this, can also contribute to polypharmacy or duplicate medications. It is important to dispose of the ‘old’ medication properly to avoid accidentally taking the old medication instead of the new one. Thyroid medication for example often requires dose changes based off Thyroid levels. If the old medication is not disposed of and taken inadvertently, you could end up taking both by mistake. Similarly, if the old medication is continued until finished and levels are rechecked, the provider could adjust the dose again based on the assumption the new dose has been started. How to help: whenever you change doses let all providers know so they can update your chart, as well as the pharmacy. Letting the pharmacy know helps ensure your old medication isn’t automatically refilled or selected by mistake. Additionally, discard old medication so it does not get mixed up at home. Patients often ask how to dispose of medication? There are several options. Police stations and the sheriff’s department can take back drugs. Some pharmacies have drop boxes. You can also purchase pouches at many pharmacies to send off unwanted medication to be destroyed.
Another common question is how to avoid multiple trips to the pharmacy? Maintenance medication can be placed on auto fill so that the pharmacy will automatically fill your medication then contact you when it’s ready. This helps ensure your prescriptions have refills and are ready before you run out. Additionally, the pharmacy can work with you to SYNC your medications to the same schedule.
There are multiple ways to help reduce the chance of inappropriate polypharmacy. Having an established relationship with your provider and pharmacist further reduce this risk. If you have any questions or concerns about your medication, reach out to your pharmacist.