Are you taking too many medications?

Medication regimens often start simply, perhaps with a multivitamin and a single prescription drug to treat a chronic condition. But with age and more health problems, a regimen may grow to include additional prescription drugs and dietary supplements (such as vitamin D and calcium), plus over-the-counter medicines to reduce symptoms such as pain or heartburn. In time, you can find yourself facing a crowded pillbox and a complicated regimen.

“Among people age 62 to about 85, a third will take five medications per person. In the higher-risk population that I take care of, those people average 15 medications per person. And some of the dialysis patients take about 20 prescriptions,” says Joanne Doyle Petrongolo, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

High pill burdens have led to a trend called deprescribing, a process of eliminating unnecessary medications. “There has been a huge push for more patients to cut down on their medications because of the potential downsides,” Doyle Petrongolo says.

The perils of many pills

It can be a hassle to take even one pill on a regular basis. But the challenge of a large drug regimen goes well beyond inconvenience. As the number of pills you take increases, so do the costs — to your insurance, and to you. Less obvious are the following potential problems.

Side effects. The more medications you take, the more chance there is that you’ll experience side effects.

Medication errors. It’s easier to get confused about which pill you took when, so you may wind up skipping a dose or taking too many.

Drug interactions. Particularly if your doctors aren’t communicating with each other about what they’re prescribing, or if you use several different pharmacies, you run the risk for drug interactions.

Drug regimen fatigue. “The more complicated a medication schedule is, the more likely it is that someone won’t take the pills as prescribed. People may pick and choose what they want to take that day because they get tired of taking pills,” Doyle Petrongolo says. “That can mean that their disease is not properly treated, and it can produce unnecessary side effects.”

Quality of life. “We’ve had some people taking medications up to five times a day, and they literally feel like their whole life revolves around taking their pills,” Doyle Petrongolo notes.

Rethinking the regimen

If you have a complicated drug regimen that is causing problems like these, you may want to consider downsizing. But don’t try to simplify your regimen on your own. That can worsen the control of your condition and increase the risk of side effects.

It’s best to speak with your doctor or pharmacist about deprescribing. “Just be very honest and say you feel like you’re taking too many pills, and ask what you can do to reduce your medications,” Doyle Petrongolo suggests.

You could schedule a drug “check-up” and bring all of your medications with you in their original bottles or packages.

If a virtual visit is more advisable, be sure your doctor or pharmacist has access (likely through an electronic medical record) to a listing of all of your medicines. And convey your own judgment about how well a particular medicine is working, particularly when you don’t think it’s helping.

When you are advised to start a new medicine, ask for how long you need to take it. “People are often started on a proton-pump inhibitor such as Prilosec [omeprazole] for heartburn, but it isn’t communicated to them how long they should take it, so they take it for years when maybe it should have only been a few months,” Doyle Petrongolo says.

Stopping a medication

In some instances, it might be safe to eliminate a pill in your regimen abruptly — for example, if you’re advised to stop taking an allergy pill or an over-the-counter painkiller like ibuprofen (Advil, Motrin) when you no longer need it.

But that’s not the case with all medicines. For example, if you stop taking an antidepressant abruptly, you could relapse into depression, or you could experience discontinuation symptoms. These symptoms can include dizziness, loss of coordination, fatigue, tingling, burning, blurred vision, insomnia, nausea, diarrhea, flu-like symptoms, anxiety, or crying spells.

During this transition, maintain a pill schedule with a log or chart. Note the medication’s time and dose, and check it off when you have taken it. Keep track of any new symptoms during this time.

In time, you may find a streamlined regimen winds up being the prescription for a better quality of life. “I had one gentleman taking 12 medications a day. We stopped two of them, and he felt like a weight was lifted. He is more inclined to take all of his medications now,” says Doyle Petrongolo.

To hear Doyle Petrongolo discuss deprescribing with Health Letter Executive Editor Heidi Godman, listen to our podcast Living Better, Living Longer. You’ll find it at www.health.harvard.edu/listen.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

 “Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.” – Philippians 4:8

 “Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.” – Mark 11:24

 “Anxiety weighs down the heart, but a kind word cheers it up.” – Proverbs 12:25

 “Who of you by worrying can add a single hour to your life?” – Luke 12:25

 “For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.” – Jeremiah 29:11

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” – Matthew 7:11

 “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” – Proverbs 17:22

Recommended contacts for prayer request and Bible study

www.agapetemplesda.com

www.adventistontario.org

https://www.hopechannel.com/au/learn/courses

breathoflife.tv/

https://3abn.org/all-streams/3abn.html

http://www.nadadventist.org/article/15/contact-us

https://www.adventist.org/en/utility/contact/

It Is Written

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