This week, Bobbi Conner talks with Dr. Gregory Fear about the issues and challenges of polypharmacy in the older adult years. Dr. Fear is a Clinical Pharmacy Specialist at MUSC Health.
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. It's estimated about a third of U.S. adults in their 60s and 70s use five or more prescription drugs regularly. And the more medicine a person takes, the higher the chance of overmedication or other problems. Doctor Gregory Fear is here to talk about managing multiple medications in the older adult years. Doctor Fear is a Clinical Pharmacy Specialist at MUSC Health. Doctor Fear give us more details about this common scenario of polypharmacy in the older adult years.
Dr. Fear: So, polypharmacy is actually defined as regularly taking five or more medications at one time. So potential issues might be somebody may have several medications on their medication list with the same indication. And some of those medications might not be effective or really have a true purpose, leading to higher potential of side effects, and the risks outweigh the potential benefits of a medication.
Conner: And are there some common categories of medicine that really aren't even appropriate when somebody gets into the older adult years, but they're pretty common.
Dr. Fear: So, this list of medications is actually known as the Beers Criteria list, which is actually something that's developed by the American Geriatrics Society. So, some examples of classes of medications on this list may include those in the benzodiazepine class or medications that have a very high what we may call anticholinergic burden. So, these might be medications that might dry you out, which may cause higher potential for say, constipation or urinary retention. And ultimately, a lot of medications on this list may increase our fall risk or medications that might increase our potential for confusion or lowering our blood pressure. So it's always important to kind of be aware of potentially certain medications that may fall on this list and consider more preferable alternatives.
Conner: And do medicines commonly affect older adults differently than perhaps 20 years previously?
Dr. Fear: Yes. So, as we get older, our stomach makeup changes over time. So that may affect the absorption of certain medications. And the other important factor is every medication is metabolized and then eliminated. Now the two main organs that are in charge of this function are mostly your kidneys and your liver. And over time, our kidneys and liver may start to work a little bit slower. So given that these medications may hang around for a longer period of time, increasing the potential for side effects. And noting that maybe there was a dose that may have been effective for us at one point, but as time goes on, we may only require a certain lower dose versus that previous dose.
Conner: So, what's the assignment then for older adults, or even a family member of an older adult to really kind of stay on top of how they're managing these medications?
Dr. Fear: List of medications is important. I think regular education is important as well. You could always ask your provider or ask your pharmacist and keep them updated if there's any concerns or side effects. One thing especially is important that every medication should have an indication or a purpose. Now, if we realize that we're kind of unclear as far as what that purpose is, it may not be needed any longer. So, it's important to kind of be aware of our medication lists and ask those questions to our provider or pharmacist, as far as what the indication of this medication may be.
Conner: Doctor Fear, thanks for talking with us about polypharmacy in the older adult years.
Dr. Fear: You're welcome.
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.
