The cost of providing health care for an older American is three to five times greater than the cost for someone younger than 65 years of age. Medication use accounts for much of this difference. The US Census Bureau reports that 80% of adults over the age of 65 have at least one chronic medical condition and 50% have at least two. Many chronic diseases are treated with one or more medications. This four-part series will introduce you to issues surrounding multiple medications use in older adults.
According to the US Centers for Disease Control over 90% of those age 65 or older use at least one medication per week, 40% take five or more, and 12% use 10 or more. Medication-related problems cost the US $200 billion a year and account for the loss of 200,000 lives.
Polypharmacy is a term that describes the use of several medications at one time, including over-the-counter medications, dietary supplements, and herbal remedies. There is no uniform definition regarding the type or amount of medications that constitute polypharmacy. As progress in medical science enables us to treat many chronic conditions more effectively, the newer treatments involve the use of more medications. So, medications can save lives; however, all medications have associated risks.
Polypharmacy significantly increases the chance for sustaining ill-effects from taking medications, including taking them improperly (the medical term for this is “non-adherence”); being the victim of a medication error; or suffering the effects of a drug-drug, drug-food, or drug-disease interaction. The risk for adverse drug reactions multiplies exponentially as the number of medications taken increases.
The elderly are at risk not only because of the high rate of medication use but also because age-related changes in physiology can render an older adult more sensitive to medications. These two factors make polypharmacy a major issue for the elderly. Being aware of the risk of medication use is your best defense against untoward effects.
| Problem | Explanation | Example |
| Medication error | Wrong medication or wrong dose or wrong time | • Wrong medication is ordered • Pharmacist fills wrong medication • Purchase the wrong medication |
| Drug-drug | A new drug you are taking interacts with another you are taking | An herbal remedy interacts with a medication you take to thin your blood |
| Drug-food | A medication you are taking reacts with a food | Grapefruit juice interferes with the metabolism of some high cholesterol medications |
| Drug-disease | A medication you take reacts with a disease you have | Many cough and cold medications worsen high blood pressure |
Part 1 What is polypharmacy?
Part 2 Who is at risk for polypharmacy?
Part 3 Tips for managing medications
This article is for education purposes only and is not meant to take the place of medical advice.
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