July 18, 2013

Prescribing Drugs SAFELY for Seniors

For anyone, taking prescription drugs – with their limitless unintended consequences – can be a tricky business. For seniors, the territory is especially perilous for many reasons:
  • We develop more problems as we age. 
  • Our aging bodies become less able to handle unexpected or adverse events. 
  • We see multiple specialists who may not know our full medical history. 
  • We use multiple pharmacies that may not know about prescriptions we fill elsewhere. 
  • We’re typically excluded from drug trials. 
  • Our own issues may prevent us from keeping track of our medications and dosages. 
  • Sometimes we don’t – or can’t – accurately communicate our problems to professionals. 
  • Most drug guidelines are based on a single-disease focus. Seniors typically have several issues. 
  • We absorb drugs differently as we age. 
  • We eliminate drug residues differently as kidney function changes. 
So many things can go wrong. Often, an adverse drug reaction is misinterpreted as some new issue. That common scenario then leads to additional testing, more and new medications, new and different adverse reactions, and lots more anxiety, discomfort, and expense. Much of this negative event cycle can be avoided if senior patients and their doctors act with care.

Several medications raise red flags by causing the most adverse events:
  • Warfarin (33% of all cases) 
  • Insulin (14%) 
  • Oral antiplateletes (13%) 
  • Oral antihypoglycemics (11%) 
Other than watching out for those four med types, what can healthcare professionals do to reduce adverse medication events? In an article published in the journal MedScape.com, Dr. Laurel Halloran offered several suggestions:
  • Always know what meds patients are already taking. 
  • Investigate possible drug-drug interactions BEFORE putting senior on new meds. 
  • Be attentive to possible patient non-adherence to medication schedules or dose. 
  • Create time to educate senior patients. 
  • Use a regular “brown bag” review, where patients brings to the office pill bottles of everything they are now taking. 
That article also cites three additional tools healthcare pros can use when deciding if a new med is appropriate for an older person:
I’ve written about several little tricks I use to help keep me on track with my meds:

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