The increasing prevalence of polypharmacy is a concern due to the potential for adverse drug interactions but also because the use of multiple meds often results in a lower quality of life for the patient.

Drug Abuse A brief interlude from addiction into a related topic: Our society’s dependence on medication. I came across this recently on a medical website:

I take ibuprofen for the headache caused by the Ramipril that I have to take for hypertension caused by the Ritalin I was given for my short attention span, caused by the Stugeron I take for the motion sickness I get from the Imodium I take for the diarrhea caused by the Orlistat I take for the uncontrolled weight gain from the Paroxetine I take for the anxiety caused by the Simvistatin I take for the high cholesterol I have because I don’t have time to exercise and eat right. 

Amusing, but also annoyingly accurate. I’d no doubt laugh harder if I wasn’t taking two of those medications myself.

The technical term for the practice of prescribing four or more meds for a patient is polypharmacy. It’s one of the major issues in contemporary geriatric medicine now that it applies to around 40% of persons  over 65 who are living at home. The increasing prevalence of polypharmacy is a concern due to the potential for adverse drug interactions but also because the use of multiple meds often results in a  lower quality of life for the patient. That’s from impairments in mood and memory, or diminished energy, cognition, balance, and mobility.

And yes, as you suspected, when such problems appear, they’re often treated with still more medications.

As noted earlier, there are cases where the use of so many medications is perfectly appropriate given the circumstances. But even then it results in an increase in a phenomenon known as pill burden. That refers to the number and variety of pills, tablets, and capsules that a given patient is required to take on a daily basis, and the familiar problem of organizing, scheduling, monitoring, and remembering to consume them. As pill burden increases, so does the risk of noncompliance, errors, accidents, falls, and ambulance trips to the ER.

The sort of incidents that ultimately result in the patient having to leave the home for a 24 hour supervision of a nursing facility.


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