Is Your Senior Loved One Taking Too Many Medications?

Here’s a word you’ll likely read and hear often in the coming years: deprescribing. It means to reduce or stop medications that are unnecessary, not beneficial or perhaps even harmful to a patient.

On average, seniors use more prescription drugs than other age groups. In 2016, nearly two-thirds of Canadians aged 65 and older were prescribed five or more drug classes, and one in four were prescribed 10 or more, according to research by the Canadian Institute for Health Information (CIHI). (A drug class is a group of medications that are similar in chemical structure, how they work, and what they’re used for. For example, opioids are a drug class.)

Medications play an essential role in health care – they save lives and help people manage their health conditions and symptoms. However, they also have side effects. For example, sedative-hypnotic drugs – prescribed for anxiety or insomnia – carry the risk of daytime fatigue, memory and concentration problems, falls and fractures, and driving accidents. The more prescription drugs a person takes, the greater the risk of harmful effects.

Physicians prescribe medications to seniors for health problems or to counteract side effects (or because side effects are mistaken for a new disease). Over time, however, medications may become less effective, or patients no longer need them. Sometimes the risks of a medication outweigh its potential benefits. Sometimes a medication is appropriate for a certain health condition, but the dosage is too high for seniors. Medications can interact with each other, possibly increasing the risk of drug toxicity. Occasionally, medications prescribed for one illness can worsen another illness.

“Currently, more than one in three Canadian seniors use at least one potentially inappropriate medication, which can lead to health risks, including falls, fractures, hospitalizations and death,” says the website of the Canadian Deprescribing Network, a group of concerned health-care leaders, clinicians, decision-makers, academic researchers and patient advocates.

The problem of polypharmacy

Here’s another word you can expect to hear more often in the future: polypharmacy. It’s defined as taking five or more prescription medications. In the medical community, the word also refers to the prescription of drugs without a specific treatment goal, drugs that a patient is already taking, and drugs that aren’t effective for the patient’s condition. “In other words, polypharmacy is the use of multiple medications that are unnecessary and have the potential to do more harm than good,” Dr. Scott Endsley wrote last year in an article for FPM, the journal of the American Academy of Family Physicians.

CIHI’s report, Drug Use Among Seniors in Canada, 2016, included these alarming findings: seniors who were prescribed 10 to 14 drug classes were over five times more likely to be hospitalized for an adverse drug reaction (ADR) than those prescribed one to four drug classes. Opioids, cancer drugs and blood thinners were the drug classes that led to the most ADR-related hospitalizations.

And here’s another key concern to be aware of: older adults are more sensitive to the effects of drugs, due to age-related physical changes: lower muscle mass and higher body fat, less efficient organs and less water in the body. All of these factors affect how we process and respond to prescription drugs, and it’s important for seniors and their families to be aware of the risks.

How to deprescribe safely

If you’re concerned about your medications or those of a senior loved one, do not reduce or stop the drugs on your own. It’s important to make an appointment with a physician, pharmacist or nurse for a medication review. With their help, you can ensure that your medications are helping, not harming.

Bring your medications with you. Discuss why you’re taking each one, what the benefits and risks are, potential side effects, and whether the dose is still correct. If a medication is not appropriate, your health-care professional may suggest a different one, or perhaps an alternative (non-drug) option. (For example, instead of taking prescription medication for acid reflux, it may help to lose weight or change your diet.)

It’s also a good idea to bring any over-the-counter medications, herbal remedies and supplements (vitamins, minerals, dietary) you take, so that your health-care professional can check for potential drug interactions.

To view our deprescribing infographic, click here.

Additional resources

Canadian Deprescribing Network
SafeMedicationUse.ca
Health Canada: Using medications safely

Bayshore Home Health offers a wide range of home care services to help Canadians live independently for as long as possible. Bayshore pharmacy home care services include medication management, medication reviews and medication reminders. We can also assist with opening pill bottles and coordinate trips to the pharmacy to ensure you don’t run out of your medications. Bayshore services are designed to support, not replace, the relationship that exists between you and your physician. Our services are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Contact us at 1-877-289-3997 for details.