The Significant Challenge in Geriatrics: Minimizing Polypharmacy
Polypharmacy, defined as the practice of administering multiple medications, continues to pose a major obstacle in geriatrics. With countless older adults on various medications that provide no advantage and may even inflict damage, the responsibility of geriatricians in de-prescribing is vital.
Reasons Seniors Become Overmedicated
Multiple factors lead to polypharmacy among seniors. Initially, there’s an enthusiasm for new medications from physicians, including geriatric specialists. For example, dementia medications were anticipated to ease symptoms or slow down the disease’s progression but have demonstrated no substantial advantages in long-term evaluations.
Additionally, there is frequently an exaggerated perception of medical benefits for prevalent conditions. While blood pressure medications are crucial, they require careful evaluation for frail elderly individuals. Striving for conventional blood pressure goals can sometimes be detrimental, resulting in problems like dizziness and falls.
Furthermore, the conventional medical field may overlook alternative healing practices and the placebo effect. For ailments like dementia, over-the-counter remedies such as Prevagen, despite a lack of extensive evidence, can offer solace through perceived improvement instead of genuine pharmacological effectiveness.
Finally, consumer-targeted pharmaceutical promotions engender a powerful, often misleading belief in drug necessity, resulting in an increase in prescriptions.
The Case for Effective Medication Management
A narrative from Dr. Donald J. Murphy’s practice underscores the significance of empowering patients in managing their medications. His patient, Elsie, opted to stop her medications and reported feeling better, illustrating the possibilities of patient-directed dose reduction, albeit with careful consideration.
Measures for Responsible Prescribing
To combat polypharmacy, patients are encouraged to communicate openly with their physicians about medication issues and potential tapering. Fostering a cooperative strategy with healthcare providers guarantees that any reduction or cessation of medication aligns with the patient’s overarching health objectives.
As healthcare progresses, transitioning from a paternalistic model to a patient-focused approach, enabling patients to make informed choices regarding their medications becomes crucial. Geriatricians must persist in advising patients on de-prescribing, eliminating harmful or unnecessary medications as part of comprehensive care.