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Too Many Meds May Be More Problem

arely a week goes by, it seems, without some company announcing a new pill designed to help you live a longer,healthier life.

Medication can, indeed, do a lot toward curing, preventing or easing many ills. But taking a fistful of pills each day creates its own set of medical risks, prompting concern among a growing number of physicians and pharmacists that people are simply taking too many medications for their own good.

“As you keep increasing the amount of prescriptions, that increases the chance of having a drug interaction or major side effect,” said Sophia De Monte, a pharmacist in Nesconset, N.Y., and a spokeswoman for the American Pharmacists Association. “It’s exponential. The more you add on, the more chance you’ll have something bad happen.”

It’s a concept called polypharmacy, the use of more medications than someone actually needs. And that means not just prescription drugs but also over-the-counter medications and dietary supplements.

The average American is prescribed medication about 13 times a year, according to a report last year by the Kaiser Family Foundation. But the likelihood of polypharmacy increases as people age. Studies have found that seniors make up 13 percent of the population but account for 30 percent of all drug prescriptions. When elderly patients transfer from hospitals to nursing homes for rehabilitation, it is common for caregivers to have to keep track of nine or more prescribed medications for each person, according to a long-term care report.

The more medications people take, the more likely it is that they’ll experience a problem in three key areas, said De Monte and Norman P. Tomaka, a pharmacist in Melbourne, Fla., including:

  • Drug interactions. Drugs can work against each other in strange ways, and the more medications added to a daily regimen, the greater the risk for an interaction that could affect the person’s health.
  • Drug compliance. Trying to keep track of multiple medications can become too much of a burden, causing people to give up trying to comply with the directions for medication use. “We’ve found that compliance drops 40 percent when you add a second drug to a patient’s regimen, even if they are both once a day,” Tomaka said. A lack of compliance to prescription directions can create a serious health risk. “For example, if you use blood pressure medication sporadically, you may set your blood pressure up to become drug resistant,” he said. Sporadic use of antibiotics can cause infectious bacteria to develop immunity to medications.
  • Side effects. Every medication a person takes comes with its own risk for side effects. Multiple prescriptions and remedies mean a multiplied risk. And once side effects occur, it can be more difficult to track down the problem. “Sometimes those drugs can mask each others’ symptoms,” Tomaka said. “If you get an adverse reaction, you don’t know which one caused it. Then you have a quandary.”

But though the trend has been toward more prescriptions, steps are being taken to safeguard patients’ health.

Doctors and pharmacists are working together to create systems by which patients’ prescription lists are reviewed, with an eye toward minimizing the medications they take, De Monte said.

“The whole goal is to try to fine-tune it,” she said, “working with the patient to get the best medication with the best effects at the minimal amount.”

Researchers also are working on ways to combine drugs that work well together into a single dose, reducing the number of pills people have to keep track of as well as the risk for drug interactions, Tomaka said.