(Maria Fabrizio for WPLN and KFF Health News)<\/p>\n
For nearly three years, Jonathan Bledsoe of Reading, Pennsylvania, took one prescription to stabilize his mood and one to keep his cholesterol in check, among a handful of other medications.<\/p>\n
\u201cYou wouldn\u2019t think you would have to be your own advocate and look out for yourself as far as managing your medications,\u201d the Marine veteran said. \u201cBut when you wake up one morning and what you pee comes out the color of fresh brewed coffee, there\u2019s an issue.\u201d<\/p>\n
He took his concerning symptoms back to his multiple doctors and learned the interaction between his medications was starting to damage his liver. After he changed medications, his liver and kidney function returned to normal.<\/p>\n
Adverse drug interactions are becoming a bigger health concern as more people take multiple medications, said Amanda Mixon, a hospitalist and associate professor of bioinformatics at Vanderbilt University.<\/p>\n
The percentage of Americans over 65 taking five or more medications, known as polypharmacy, nearly doubled from 2000 to 2020, according to a study published in JAMA Internal Medicine<\/a>. Now, more than a third of older adults are taking five or more medications a day.<\/p>\n Mixon said she sees older patients with an average of 16 medications, often from multiple prescribers and pharmacies.<\/p>\n \u201cAs you accumulate more and more medications, the chance of them interacting with each other and having bad interactions increases,\u201d Mixon said. \u201cAs these medications get added sort of progressively, that can accumulate over time, and then people are having more side effects.\u201d<\/p>\n The QTip:<\/strong><\/p>\n If you\u2019re taking medications and supplements, keep your own up-to-date list and have it with you.<\/p>\n If you\u2019re concerned about your medications, here\u2019s what to know:<\/p>\n There\u2019s No \u2018Unicorn Pharmacist\u2019<\/strong><\/p>\n Sometimes, a medication intended to treat one issue leads to many more, known as a \u201cprescribing cascade\u201d: A prescription for the initial symptom causes a side effect, then that side effect needs to be treated. Eventually, the combination of meds may cause other issues that require yet another medication.<\/p>\n For instance, Mixon said, heart failure patients take a water pill to reduce fluid retention. As a result, the constant need to urinate can lead to incontinence, which is treated by another medication.<\/p>\n \u201cWe do an amazing job of treating. We are great at diagnosing, and medicines have an amazing role in increasing our longevity as humans,\u201d said pharmacist DeLon Canterbury<\/a>. He\u2019s the CEO of the North Carolina-based consulting company GeriatRx, which focuses on helping patients get off unnecessary medications. \u201cIt\u2019s not the intent of our providers to overtreat. It\u2019s just what we\u2019ve been trained to do.\u201d<\/p>\n When multiple prescribers are involved, they may not be aware of the patient\u2019s other medications, he said, especially if the health providers are affiliated with different health systems that have separate patient records.<\/p>\n \u201cDo not assume that someone is checking all of these things in the background. There isn\u2019t this magical unicorn pharmacist just making sure everything is safe. Yes, even at the local pharmacy,\u201d Canterbury said. \u201cSo make sure, if you notice something is off, that you advocate for yourself.\u201d<\/p>\n A Shift Toward \u2018Deprescribing\u2019<\/strong><\/p>\n \u201cDeprescribing,\u201d the process of intentionally tapering off medications, has gained more momentum<\/a> in the past decade, alongside the corresponding rise of polypharmacy and the associated health risks.<\/p>\n The science on how to taper patients safely is newer and still not widely taught in medical schools, Canterbury said.<\/p>\n He said patients who are worried about taking multiple medications \u2014 especially people experiencing a new symptom or an unexpected side effect \u2014 should start a conversation about deprescribing with their specialists or primary care providers.<\/p>\n \u201cI promise you, they don\u2019t bite,\u201d he said. \u201cBecause you\u2019ll be surprised that the more you bring up stopping a medication, the more willing they are to actually have that dialogue and help you get off of it if you don\u2019t need it.\u201d<\/p>\n The goal isn\u2019t kicking as many meds as possible, Canterbury said \u2014 it\u2019s patient safety. With age, bodies metabolize medications differently, he said, increasing the likelihood of harmful side effects like constipation, diarrhea, falls, and memory loss.<\/p>\n Keep a Medication List<\/strong><\/p>\n Many pharmacists and doctors agree on the value of keeping an updated medication list, including the vitamins and supplements you\u2019re taking. While there are QR code bracelets and medication tracking apps, sometimes the easiest strategy is an old-fashioned piece of paper.<\/p>\n \u201cEveryone needs a medication list in their pocket,\u201d said pharmacist Jen Hammons, director of rural health advancement at the Appalachian College of Pharmacy in Virginia. \u201cIf you can\u2019t commit it to memory, you need to have a list.\u201d<\/p>\n People and Policy<\/strong><\/p>\n Health and Human Services Secretary Robert F. Kennedy Jr. has championed weaning Americans off psychiatric medications that he says are overused, a stance that has polarized the medical community. This year, the Centers for Medicare & Medicaid Services released guidance<\/a> that clarifies how physicians and pharmacists can be paid for their work reviewing medications and helping patients taper off when appropriate. Previously, physicians reported uncertainty over whether they could get paid for deprescribing, which can be a time-intensive process.<\/p>\n Katherine Ruppelt and<\/em> Emily Siner at Nashville Public Radio contributed to this report.<\/em><\/p>\n HealthQ is a health series from reporters Cara Anthony and Blake Farmer, approachable guides to an unapproachable healthcare system. It\u2019s a collaboration between Nashville Public Radio and KFF Health News.<\/em><\/p>\n<\/div>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":" (Maria Fabrizio for WPLN and KFF Health News) For nearly three years, Jonathan Bledsoe of Reading, Pennsylvania, took one prescription to stabilize his mood and one to keep his cholesterol in check, among a handful of other medications. \u201cYou wouldn\u2019t think you would have to be your own advocate and look out for yourself as…<\/p>\n","protected":false},"author":0,"featured_media":16199,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-16198","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/16198"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=16198"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/16198\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/16199"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=16198"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=16198"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=16198"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}