As the title asks, can my parents have too many prescriptions? This is a serious problem for seniors. A survey done in 2019, found that more than half of adults 65 and older (54%) said they took four or more prescription drugs. Approximately 30 percent of seniors use some type of OTC or herbal drugs. Many people think that taking herbal remedies is safer because these products are “natural”. But, they can affect the body just like prescription drugs. Meaning that they can either add to or work against the effects of medications prescribed by your parent’s doctor(s).
I don’t know about you, but when I used to look at all the medicine my mother took there were times I was overwhelmed (and I was a pharmacist!). As a diabetic, my mother took medicine for the diabetes, high blood pressure, high cholesterol, glaucoma, and this doesn’t being to take into account all the over-the-counter (OTC) medicines, and herbs and vitamins she took. In addition she saw multi doctors who continually prescribed new things for her. When someone takes 5 or more drugs per day it is called polypharmacy. Does this sound anything like your parents (or even you)?
But really, how many are too many prescriptions?
Why is polypharmacy a problem?
Polypharmacy happens most frequently in seniors, because they are more likely to have one or more chronic conditions with longer medication lists. Think of diabetes, they get medicine for the diabetes, but also cholesterol, high blood pressure, and maybe even a children’s aspirin. Many older adults see multiple specialists and if they have no primary care physician they are especially at risk for polypharmacy. This in turn can lead to a lower quality of life, problems moving, and even an increased risk of death.
What can I do to help my parents with polypharmacy?
The first thing you should think about is getting a full list of everything your parents are taking. This includes prescription drugs, OTC drugs, herbal products, and any other thing they take for their “health”.
You can create a master list that includes at least the following items:
- the name of the medication,
- are they still taking the medication,
- how your really parents take the medication (this may not be the same as the instructions on the label), and
- where they get the pills (this is especially important for the herbal products).
If there is other information you think is important, include it.
If it helps, you can take photos of the bottles and store them in an app.
The next step is to have a medication reconciliation or med rec done or join a medication therapy management program.
So what is medication reconciliation or a med rec?
“The process of identifying the most accurate list of all medications that the patient is taking, including name, dosage, frequency, and route, by comparing the medical record to an external list of medications obtained from a patient, hospital, or other provider.”Medicare
Okay, that is fancy language for what happens. Basically a pharmacist compares the medicine that your parents are taking against a list from the doctor. The hard part is to make sure you have information from all the doctors your parents are visiting.
I thought this already happen, when they visit their doctor or get a prescription filled?
The short answer to the question is “no”.
Unfortunately, in the United States there is no record where all the hospitals, doctors, and pharmacist can see all of the prescription drugs your parents are taking. Even a record like this existed; it wouldn’t include the OTC and herbal medicines your parents might be taking.
When your parents (or you) get a prescription filled at any pharmacy, the pharmacist only knows the prescriptions filled within their chain. For example, they get some prescriptions at CVS and other prescriptions at Costco. The two computer systems don’t talk with each other. Meaning that the pharmacists don’t know what prescriptions the other chain has given your parents. This creates problems because it can lead to duplication of prescriptions, interactions between drugs, and other side effects.
Something similar happens with doctors, your parents may see multiple specialists and they may or may not have a primary care doctor. Many times these doctors’ offices don’t talk with each other. So this means that no one has a complete listing of the prescriptions your parents get.
How do I get one for my parent(s)?
If your parent is admitted to the hospital for any reason, Medicare will pay for a for a medication reconciliation as long as it happens within 30-days AFTER they have been discharged. So make sure this is done for your parents (and don’t forget to include OTC and herbal products!).
What if my parent hasn’t been in the hospital?
If your parent has been fortunate enough not to be admitted to the hospital then they may be able to take part in FREE medication therapy management (MTM) programs offered by their insurance company. MTM programs target people who:
- have a combination of health issues or chronic diseases,
- take several prescription and non-prescription medications,
- have had trouble managing the various medications you take,
- the medications require a health care professional to monitor them closely, or
- if your parents get their medications from multiple pharmacies.
To find out if your parents plan covers their participation in a program, call their Part D or prescription drug coverage plan. Be sure to ask about the specifics of the program, such as where to go for services and how often they should receive a review.