Because older adults typically have more chronic illnesses than the general population, they take more medications. Adults age 65 and older make up about 15 percent of the population but are taking 34 percent of all prescription medicines and 30 percent of over-the-counter drugs. More than 88 percent of older adults take at least one prescription, and 37 percent take five or more prescription medications.
Managing those multiple medicines can be tricky, but it’s important to find a system that helps you take correct dosages on time every time to avoid the risk of taking too much or too little of a drug.
Your first step might be to talk with your pharmacist or physician about evaluating your entire prescription profile. Because so many of us have multiple doctors prescribing multiple medications, it’s easy to have some overlap or even duplication. Called polypharmacy, this can lead to over-medication and dangerous reactions. Older adults are at increased risk of serious events from polypharmacy, including falls, depression, confusion, hallucinations and malnutrition, and these are an important cause of illness, hospitalization and death among these patients.
One potential reason for these negative outcomes is the natural changes we face as we age, such as how well our bodies absorb, distribute, metabolize and eliminate medications.
Regular evaluations with your pharmacist or physician will help prevent dangerous doubling up, as well as potentially harmful interactions. You also should talk about whether a medication is no longer needed (perhaps the problem has been resolved).
It is also important to track all of your medications. Keep an ongoing list that includes all of your medications, including supplements and over-the-counter drugs, the dosages for each, the doctor who prescribed them and the reason for taking them. And reevaluate your medications after a hospital stay, where you are likely to be prescribed additional drugs. Keeping this list current will make it easier for you to inform health-care providers at future appointments about everything you’re taking.
Because older adults tend to take several medications, it is important to schedule times and dosages. Taking multiple medications can be confusing, with plenty of room for errors — for example, forgetting to take a dose or taking it on an empty stomach when you were supposed to take it with a meal. Using a calendar can help keep you on schedule, as well as using compartmentalized pill organizers (using one color for your morning medications and another for evening, or using three separate colors for each mealtime).
There are also several smartphone apps available for managing multiple medications, from those that send reminder alerts when it’s time to take medications to broader services, such as comparing medication prices locally, ordering refills, general information about adverse effects and dangerous drug interactions.
If possible, try to use the same pharmacy to fill all of your prescriptions. That way, you can get to know the pharmacist, and he or she can look at your entire prescription profile to prevent negative interactions as you add new prescriptions, over-the-counter products and supplements.
Dr. Kevin B. Sneed is professor and dean of the USF Health College of Pharmacy.