A new approach called “de-prescribing” is being implemented by physicians across the country. This means reducing the excessive use of prescription drugs, as well as over-the-counter medications and supplements. Doctors hold medication reviews, identify side effects and interactions, and then wean patients off drugs that are unnecessary.
Nearly 40% of patients in their 60s take more than five medications (polypharmacy). This happens when people see different doctors who don’t coordinate care with each other. Patients should be asking their physicians, “Is this drug still right for me?” and finding out what other drugs or therapies may be safer or more effective. The body processes many drugs less efficiently as it ages.
Canadian geriatrician, Cara Tannenbaum, has developed a website called deprescribing.org, which is used by both U.S. and Canadian doctors to provide information to help patients determine which medications may be unnecessary or cause harm. Statins may not be as needed over age 75, as they also cause muscle weakness and increase risk of falling.
The American Geriatric Society updated its Beers Criteria, a list of 40 medications or types of drugs potentially inappropriate for older adults. Last year, the panel added three new drugs and two classes of medications to warning lists for older people. The lists and suggested alternatives are available at HealthinAging.org. Medication regimens must be personalized to each individual patient, as some drugs are more effective on some than others.
A study by Dr. Tannenbaum found that educating patients can help reduce the overuse of risky medications, such as benzodiazepine. After six months, 27% had discontinued using the sedative after having a discussion with their doctor. There are new warnings about using proton pump inhibitors, which are linked to an increased risk for bone loss, fractures, and bacterial infections. They can also reduce the effectiveness of blood thinners and increase risk of heart attack.
Stopping drugs “cold turkey” can worsen symptoms. Patients need to taper down over several weeks as directed by their doctor to avoid a bad reaction. Keeping up with exercise, rest, meditation, and a nutritious diet are important to maintain strength. The goal is to keep patients healthy with the least amount of medications.
Landro, Laura. “When Patients Take Too Many Pills, Doctors Deprescribe.” Articles. The Wall Street Journal, 10 Oct 2016. Web. 11 Oct 2016.