Too many pills exacerbate perils of aging

Polypharmacy among older patients is a long-recognized problem. Experts are calling for heightened attention to strategies to prevent it.

By Victoria Stagg Elliott, AMNews staff. March 26, 2007.

While pharmaceutical advances have improved the quality and length of life for many older patients, there is still a dark side that requires attention.

That dark side involves medication overuse and the associated risk of adverse events. Strategies to address these persistent problems need to be implemented more widely, according to presentations at the 2007 Joint Conference of the American Society on Aging and the National Council on Aging, held March 7-10 in Chicago.

"A lot of prescribing is actually good medicine, because there's a lot more options for prevention," said Roger Weise, MD, medical director of the Alexian Older Adult Institute in Elk Grove Village, Ill. "But polypharmacy is an everyday occurrence in doctors' offices, nursing homes and hospitals, and the use of multiple medications can reduce a patient's optimal function."

Dr. Weise, who was among the presenters, once treated an older woman brought to the office by her son. He was concerned about her increasing confusion and forgetfulness. She also was incontinent and constipated, had stopped eating properly, no longer kept her home well and was wearing the same clothes day after day.

After some basic investigative work, the problem was clear. In the course of seeking relief for back pain, she visited numerous doctors who prescribed an even higher number of pills. She also took over-the-counter medications for this pain and other symptoms. Thus, the dozens of pain pills, along with several cardiovascular drugs, triggered her difficulties.