Medications: Too Much of a Good Thing?

Medications are good for you – right? “Take this prescription, it will make you feel better or live longer.” Will it? If your head is already spinning do not fret. Doctors are confused too. Your heart specialist gave you two new drugs to take, and one more from the urologist, and another two from the diabetes specialist. That does not even include what your primary care doctor is prescribing.

Trouble is, most scientific studies develop treatment guidelines based on test subjects who may not resemble the typical older adult who suffers from many illnesses and takes even more medications. These sicker folks are usually left out of studies because they are too complicated.

So when a doctor tells you, “take this blood pressure pill to lower your pressure further” it might do its job so well that you fall over from low blood pressure. Will long-term benefits of lowering cholesterol make a difference in a 90 year-old who doesn’t necessarily have “long-term” to live? Do the side effects of loss of appetite and stomach upset negate the questionable benefits of memory medications? Be aware of myth #8 from the Alzheimer’s Association web site:

Myth 8: There are treatments available to stop the progression of Alzheimer’s disease

“At this time, there is no treatment to cure, delay or stop the progression of Alzheimer’s disease. FDA-approved drugs temporarily slow worsening of symptoms for about 6 to 12 months, on average, for about half of the individuals who take them.”

And then there is the cost to consider.

A recent report, in fact, found that bad reactions to medication lead to 1.1 million emergency department visits every year. What’s more, about one third of these folks who are over age 50 get admitted into the hospital! A 2011 report from the Agency for Healthcare Research and Quality (AHRQ) found that bad reactions to medication has increased 50% in recent years, leading to over 2.7 million hospitalizations or emergency room visits. Some of the worst culprits were antibiotics, valium-like drugs, narcotic pain medication, insulin, blood thinners, steroids and heart medications.

Several studies have found one simple red flag for increased risk of bad reactions to medications: The more medications, the greater the risk. Sometimes things are clear and simple.

Sources

  1. Adverse reactions to medications account for over 1.1 million emergency department visits by older Americans each year. http://www.oas.samhsa.gov/2k11/DAWN013/AdverseReactionsOlderAdults_HTML.pdf
  2. Alzheimer Mythshttp://www.alz.org/alzheimers_disease_myths_about_alzheimers.asp
  3. “Primary care clinicians' experiences with treatment decision making for older persons with multiple conditions.” Arch Intern Med. 2011 Jan 10;171(1):75-80.
  4. “The relationship between number of medications and weight loss or impaired balance in older adults.” J Am Geriatr Soc. 2004 Oct;52(10):1719-23.
  5. Medication Side Effects, Injuries, Up Dramatically. AHRQ News and Numbers, April 13, 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/nn/nn041311.htm