This week Bobbi Conner talks with Dr. Kelly Graves about managing medication in the older adult years. Dr. Graves is an Assistant Professor of Medicine and a geriatrician at MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Adults 65 and older tend to take more medicines than any other age group, since they may have several health problems going on at the same time. Dr. Kelly Graves is here to talk about managing medication in the older adult years. Dr. Graves is an Assistant Professor of Medicine and a Geriatrician at MUSC. Dr. Graves, what are some of the common issues or challenges that come up related to managing medication, specifically in the older adult years?
Dr. Graves: So there's a few different issues that we commonly see. One of them is polypharmacy, and that's having too many medications that are inappropriate or not in line with a patient's goals of care or what's important to them. A lot of times, these medications may be inappropriate because of side effects that are more common with age. And a lot of times with those side effects, we see something that's called the prescribing cascade, where we actually add a new medication in order to treat another medication side effects instead of stopping the offending medication. The other big issue is just obtaining and maintaining an accurate medication list.
Conner: How common is it that medications for chronic conditions need to be changed? Even though a patient may have been taking this medicine for many years?
Dr. Graves: This is very common for a number of reasons. Mainly, our bodies naturally change with age, and with that how we absorb and metabolize medications is likely to change. For example, if there's a natural decline in kidney function with age, some medications that are processed or metabolized by the kidneys may hang around longer or may need a smaller dose compared to years earlier.
Conner: Are there cautions to mention about over-the-counter medications, specifically in the older adult years?
Dr. Graves: Yes there’s lots of caution over the counter. Supplements can have side effects, just as any medications and can interact with even the prescription medications. Most sleeping medications, even over the counter, have significant risks of confusion and falls. Pain relievers, such as ibuprofen can cause bleeding, ulcers or even affect the kidneys. Aspirin's one of the most underreported medications. Just because it is over the counter or called baby aspirin, does not mean that it's safe or harmless for everyone. So, it's most important to let your doctor know any over the counter supplements you're taking. Or even better, bring them to your appointment with you.
Conner: Are there any new ways of organizing daily medicine that might be helpful, especially for older adults?
Dr. Graves: Yeah, so there's a lot of different pill boxes that are available now, including some that are automatic or smart dispensers. These are often set up weekly by family members. And then the dispenser actually alerts the patient that it's time to take their medications, either with a light or sound, and dispenses the medications. And, family members or caregivers can then get alerts through an app if the medications were taken or not. Another option is what's called a blister pack, where medications are bundled together based on the time they should be taken each day. This is often done at your local pharmacies and can help with not forgetting doses and reducing some of the burden on family or caregivers.
Conner: Dr. Graves, thanks for this information about managing medication in the older adult years.
Dr. Graves: Thank you for having me.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming
