4 Tips to Help Prevent Medication Complications

About Kim Elliott

Chief Nursing Officer

When it comes to leading clinical programs, Kim is our go-to authority on resident care, while maintaining the highest standards for quality and compliance. As Chief Nursing Officer, her care philosophy is based on the importance of individualized care, personal choice and resident independence. Kim is dedicated to finding more options to help our residents live and age well. That’s why she has taken a population health approach to surrounding our residents with the healthcare services they need to help manage their chronic conditions. Kim’s passion for senior healthcare developed in nursing school during a routine rotation. When she saw a shortage of quality nurses working in senior living, Kim knew she had found her calling and a place where she could make a difference. Kim joined Brookdale in 2014. She serves on the Argentum Clinical Quality Executive Roundtable, is on the Dean’s Advisory Board for the Central Florida University School of Nursing and is a member of the Nightingale Society. She was recently inducted into McKnight’s Women of Distinction Hall of Fame. Kim has a master’s degree in Nursing, with a specialty of executive leadership from Chamberlain College of Nursing.

The doctor knows best. That’s typically our mentality when we are diagnosed with an illness or prescribed medication. However, that notion can get complicated with age and as more chronic conditions present themselves. These chronic conditions lead to more doctors’ appointments, varying treatment plans and a multitude of prescriptions. The effects of taking multiple medications to manage co-existing health problems is called polypharmacy. Medication side effects and interactions can cause deadly harm, and seniors are especially at risk.

Recently, I talked with Todd King from Omnicare to explain polypharmacy, its threat to the senior population, and what patients and health care providers can do to stop it.

What is polypharmacy?

The National Council on Aging reports that approximately 80% of older adults have at least one chronic disease and 77% have at least two. Research shows that roughly 25% of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions, and that number jumps to 46% for those between 70 and 79. Those numbers don’t include any over-the-counter medications, vitamins or supplements, which might also cause a myriad of side effects or drug interactions.

There are three types of polypharmacy:

Overuse is too much of a good drug. For example, overprescribing the appropriate dosage or prescribing multiple medications for the same condition.
Underuse is too little of a good drug. For example, not optimizing a treatment plan or non-adherence by the patient.
Misuse is the wrong drug and/or at the wrong time. For example, prescribing a potentially inappropriate mediation or taking it incorrectly.

Some medications pose more of a threat than others. Closely monitoring for drug reactions, eliminating unnecessary or potentially dangerous medications, and optimizing non-medical treatments will decrease the risk of polypharmacy.

What are the risks of polypharmacy?

Polypharmacy can lead to increased healthcare costs, increased hospitalization, poor drug adherence or increased side effects and drug interactions. In most dangerous cases, drug side effects may be mistaken for a new medical condition, and then treated with a new prescription.

These conditions can put you more at risk for polypharmacy:

Multiple doctors prescribing multiple medications
Multiple pharmacies filling prescriptions
Taking high-risk medications
Taking a large amount of medications
Poor diet
Failure to know about side effects, interactions, dosage or other adverse effects when ordering drugs
Failure to monitor drug therapy appropriately

Any of these issues can increase the dangers of polypharmacy, which includes symptoms such as cognitive impairment, frailty, low blood sugar, low blood pressure, weight loss, urinary incontinence, falls and fractures or bleeding.

How can you prevent polypharmacy?

Patients and clinicians can work together to decrease the risk of polypharmacy. Here are a few tips:

Keep an up-to-date list of current medications including dosage and over-the-counter drugs, vitamins or supplements. Share this list at every doctor’s appointment.
Use one pharmacy to fill prescriptions.
See as few prescribing physicians as possible.
Take note of any adverse side effects and share these with your doctor.

Polypharmacy is complicated, but closely monitoring for side effects and communication between patients and physicians can lower the risk.

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