Why It’s Important to Review Your Medication List with Your Doctors
Taking five or more prescription medications (called polypharmacy) is more common than most people realize. Research shows that it is very common among older adults. Usually, this is because the person has several chronic conditions. That’s why health care providers tend to add medicine. The problem? The chances of having poor outcomes go up the more medication you take. Your palliative care team can make a difference.
By spending time talking with you about your medication and your quality of life, your palliative care doctor can find out if you are taking some that are no longer essential. They will report back to your primary care doctor and other doctors that you see (e.g., cancer doctor).
Together they may take away some medications that are no longer necessary. This can eliminate side effects that may be affecting your quality of life. What will this look like?
Share your medication list with all of your doctors
To start, it’s important to make sure that all of your doctors know the medications you are taking. They will carefully review your medical records and medication list. And they will ask you some specific questions (e.g., do you still need your proton pump inhibitor?). If they don’t ask, make sure that you start that conversation. And as mentioned earlier, if you’re also seeing a palliative care doctor, they will go through your medication list with you, and work with your other doctors.
Examine your medication list
Make sure that you and your doctors carefully examine the list of medications you’re taking. How many are there in total? If the list shows more than five, know that this is associated with worse outcomes, especially in older adults. Research tells us that older adults are at greater risk for experiencing bad drug reactions in general, and the risk goes up the more medications you take.
Think about timing
Have you been taking a particular medication for a long period of time without a break? Do you still need to take it? Maybe the medication’s benefits have run their course and could be stopped.
Sometimes people may not think to ask, “How long have I been taking this medicine, and should I keep taking it?” But your doctor should ask this question! If they don’t, you should.
Is each medication needed?
Some people may not even know whether they still need a particular medication. Make sure to ask your doctor. Another issue to consider is that you may be taking a medication originally prescribed to counter the side effects of another medication. Are you even still taking the original one? If not, you may no longer need to be taking it. Your doctor should check with the doctor who originally prescribed the medicine.
Some common, overprescribed medications
Certain medications are “usual suspects” for being overprescribed. As a 2019 study in the Journal of Clinical Medicine Research found, the most common overprescribed drugs tend to be: pain medicine, medicine for acid reflux, hormone replacement medications (e.g., levothyroxine), and antidepressants. However, this depends on your stage of life, especially if you’re an older adult. The list may change as you get older.
High-risk medications to be aware of
You should be especially careful about high-risk medications . One category in particular, especially for older adults, is anticholinergics (e.g., amitriptyline). These are prescribed for a variety of conditions such as Parkinson’s disease and chronic obstructive pulmonary disease (COPD). They are known for causing dizziness, fatigue, cognitive changes, and other symptoms that can impact a patient’s quality of life. And this category of medications is associated with an increase in death as well as permanent cognitive damage in older adults.
Conclusion
Our medications need to change as we get older. What might be right for a middle-aged person could be quite different from what’s appropriate for an older adult. So, always review your list of medications with all of your doctors (including your palliative care team) to make sure that the benefits of the medication outweigh the risks.
About GetPalliativeCare.Org
GetPalliativeCare.Org is an online resource for patients and families that focuses solely on providing information on palliative care from the point of diagnosis. At GetPalliativeCare.org you can take a short quiz to see whether you or a loved one could benefit from palliative care. The site is provided by the Center to Advance Palliative Care.
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