Taking too many medications increases risk of side effects

Almost one million Australians aged 70 and over take five or more medications daily.

Multiple meds put over-70s at risk

Almost one million Australians aged 70 and over take five or more medications daily, placing them at increased risk of unwanted side effects, more frequent hospital admissions, and falls.

The most recent figures, taken from a joint University of Western Australia and University of New South Wales study, found that the number of older people taking five or more medicines increased by 52 per cent between 2006 and 2017, despite evidence that this practice places patients at risk of harm and is associated with poor clinical outcomes.

Dr Mark Morgan from the Royal Australian College of General Practitioners (RACGP) said that while polypharmacy is sometimes seen as an ‘inevitable’ part of ageing, GPs should be able to engage in targeted de-prescribing.

“Many GPs have observed how patients gather medicines as they gather specialists,” he said.

“It is hard for our specialist colleagues to reduce or stop medicines that were recommended by a different speciality. How confident will a cardiologist be at changing gynaecologist medications?

“The GP role in reducing inappropriate polypharmacy is central. GPs are uniquely placed to be able to determine patient values, to understand social circumstances and to be able to identify medicines for de-prescribing.”

Dr Morgan said that while many GPs will reduce and cease medications as part of palliative care, de-prescribing should be considered in any patient with polypharmacy. As an example, he pointed to a pilot study he helped conduct that assessed systems of care used to achieve de-prescription and increase patient safety.

“We identified over 75-year-olds at high risk of hospital admission, then used the senior health assessment to establish patient priorities for care. Patients entered a multimorbidity care plan and quarterly review cycle that allowed the GP time to taper medications,” he explained.

“Simple steps to improve safety included reconciling the medication list, checking patient renal function and standing blood pressure.

“The project identified many patients who were at risk from over-treatment of diabetes and blood pressure. Other patients were taking medicines that were part of a prescribing cascade where side effects from one treatment led to prescriptions for the next and so on.”

The latest research, based on a 10 per cent random sample of people eligible for medicines listed on the Pharmaceutical Benefits Scheme between 1 January 2006 and 31 December 2017, found people in their 80s are most likely to take five medicines or more a day.

Lead researcher Dr Amy Page believes that while the increase could be attributed to a growing ageing population, more needs to be done to ensure medication management balances the potential for benefits against the potential for harm.

“The medicines we looked at do not include medicines purchased without a prescription, such as vitamins, minerals, herbal supplements or medicines not listed on the Pharmaceutical Benefits Scheme, meaning that the estimates in the paper may be conservative,” Dr Page said.

“The rates in comparable years are also much higher in Australia than in the US or the UK.”

Dr Page also said that strategies targeting both health professionals and the public, and which seek to increase people’s understanding of the potential risks involved in taking multiple medications, are needed.

“Taking multiple medications may be necessary, but it needs to be carefully assessed by a medical professional and balanced against the potential risks.”

How many medications do you take on a daily basis?

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    COMMENTS

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    Bushbaby
    17th Jul 2019
    10:47am
    This struck a chord with me! Until about 18 months ago, I was taking 8 prescribed medications plus 5 supplements on the advice of doctors plus periodically being prescribed heavy duty pain killers in addition to the regular pain killers that I had to take every day. In spite of continual requests to review all the medications, every doctor I asked simply looked at the list and said they all looked ok and to keep taking them. Eventually I became very ill and at that point conducted my own personal revolution. I threw all the medications out and waited to see what would happen. Boy, was I surprised. My diabetes which I had been assured was irreversible and absolutely required lifelong treatment, became stable and responded well to diet modifications. All the other conditions I supposedly had suddenly disappeared and needed no treatment. The only ongoing medical issue that did need treatment was high blood pressure. To this day, I take only minimal medication for HBP and very occasionally antibiotics if absolutely necessary. My health is so much better and I don't need pain killers at all. How much damage is being done to older people's health and well being by the overuse of sometimes unnecessary medications? Judging by my own personal experience, I would say quite a lot. This is not to discount the situations where people do need ongoing treatment such as for Insulin dependent Diabetes and some other serious conditions. I think we may have become conditioned to just accept whatever we are told by professionals who may, or may not, have our overall health situation clearly in front of them when prescribing. Apart from the reasons stated in the article, I think there is also the issue of doctors being under extreme pressure to get as many patients dealt with as possible in impossibly short time frames. So many times there is very little time allowed for each consultation and this can lead to many problems. I really don't have any answers and can only relate what I did myself to address the situation.
    ROB
    17th Jul 2019
    12:31pm
    Such a common result Bushbaby and well done to you. We even have Photobiomodulation patches available now that replace dangerous Stem Cell treatments, taking away the risks of the injected substances with these procedures. These patches work on light communication with the body for near immediate powerful positive effects, easy for anyone to use, extremely effective and a fraction of the cost of traditional procedures. The more we can keep away from risky, dangerous drugs and substances being ingested or induced into our body the healthier we will be.
    *Loloften*
    21st Jul 2019
    5:41am
    Goodonya Bushbaby - currently requiring tests for fairly minor stuff b/c of simple vitamin recommendations by my GP, may have over-dosed (followed recommended!?). Have stopped taking the vitamin supplements, weird symptoms improved but booked in for the tests so will do....just in case!?
    *Loloften*
    21st Jul 2019
    6:05am
    My Father-in-law became really unwell, finally begged to go to hospital & I was the only family member available (on hols for a wk then, Mum-in-law couldn't drive...never had done. We packed up all his medications in a bag prior to hospital arrival & altho' he was OK to walk very slowly whilst hanging onto to arm tightly, was obviously really unwell/in pain & quickly admitted to hosp. Long saga...short story is that he'd been prescribed, since WW11, 16 various pills over the decades by his GP & they were killing him. When the hosp specialists did all relevant tests, cut him back to just 6 pills daily & he happily lived for another 20yrs, 'til 93. Drs, like us all, make mistakes but when they do, it can be fatal. Always seek a 2nd opinion.

    17th Jul 2019
    11:10am
    Our doctor is very experienced and a bit older than us and takes the time to review our medication each and every time that scrips need renewing. He is quick to change the medication or dosage if necessary and is also a believer in natural remedies. His only caution with natural remedies is that he asks us to check with him before taking them in case there is a conflict between the natural product and pharmaceutical drugs. We have a friend who used to be a doctor's receptionist and she told us of a group of doctors who would renew scrips without seeing the patient.
    KSS
    17th Jul 2019
    12:37pm
    Polypharmacy often develops due to side effects of one medication. Another pill is prescribed to counter that then another side effect demands alieviation and so it goes. Unfortunately, some poeple go for years without their medications being reviewed as to whether they are still required or even if they are the right medication still.
    disillusioned
    17th Jul 2019
    1:26pm
    I am hypersensitive to chemicals, including medications, and tend to get the side effects before I get the good effects, if any. Over the years, I've had antidepressants that hyped me up, or made me so lethargic all I wanted to do was sleep. Finally I gave them all up, had some counselling and use CBT. which seems to work OK, after all, I figure there's nothing wrong with having a few "down" days! I now take a very small amount of blood pressure medication at night, and vitamins in the morning, and this regime seems to suit me better. I also attend an exercise class twice a week, eat a reasonably healthy diet, and get out and about while I still can!
    fishy
    17th Jul 2019
    1:28pm
    I find this strange that people are taking their life into their own hands when you can get a qualified nurse that calls into your home and will check all your medication all that is needed is to ask your doctor as was done by me for my mother and both my in laws
    It makes a great headline everyone is taking x amount a day but any study that gets a headline is only looking for funding and why tell the truth as it would seem the media also took the bait
    KB
    17th Jul 2019
    2:49pm
    My mother had a fall,. Had her own medication by her own doctor. More medication was added in hospital. Went to a nursing home for respite care. Needless to say more medication was added.When she went home she had 20 types of medication This type of situation must be better managed . As for myself I only take one medication . Allergic to many so put my foot down about being prescribed medication.
    KB
    17th Jul 2019
    2:49pm
    My mother had a fall,. Had her own medication by her own doctor. More medication was added in hospital. Went to a nursing home for respite care. Needless to say more medication was added.When she went home she had 20 types of medication This type of situation must be better managed . As for myself I only take one medication . Allergic to many so put my foot down about being prescribed medication.
    Thoughtful
    17th Jul 2019
    2:55pm
    I believe taking 5 or more medications makes you eligible for a Medication Review by your community pharmacist.
    TOR888
    17th Jul 2019
    3:27pm
    I keep saying to my Dr that all my current levels are really good so can I stop taking my meds!!! He always gives me the same answer..if you were not on these meds you would be cactus....
    OnlyDaughter
    17th Jul 2019
    4:45pm
    I need an asthma preventer and a reliever plus a daily tablet to stabilise my variable blood pressure - 150/80 one moment and 100/60 the next, inherited from my Mum. However, I am concerned at my 94 year old Mum’s meds. Mum has vascular dementia and mental illness and can be difficult in the extreme, behaviour wise. She is a nightmare to deal with, She has two medications for her blood pressure and her heart, Epilim because doctors think she has small seizures like petit mal, Risperidone to manage her behaviour and an anti-depressant again for her behaviour and her outlook which can be very confrontational. I have tried to get doctors to take her off the Risperidone because I don’t think it helps her aa from everything I have read it doesn’t help the elderly and has some potentially fatal side effects. We have a medication review coming up and I am hopeful they will listen this time. Sadly , my Mum is physically brilliant but mentally.................sigh.
    Irishwolfhound
    29th Jul 2019
    12:55pm
    There are many really good caring Doctors out there. Then there are the ones that are in the job for the money, just like all the other hawkers out there! You have to look up all the facts about you own health as you can and decide what is going to work for you. After al how many patients does your Doctor see in a day? One every five minutes, by 10 hours -10x5 is 60 a day. That is a lot of money to be earning, even when you consider how many years they worked to get their degree. Always get a second opinion from someone or somewhere.Well done! Enjoy a happy and healthy "rest of your life" !


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