Have you ever heard of the word “polypharmacy”? I saw the word for the first time today. It’s generally defined as taking many medications together. There’s been debate over how many is “many,” but a number generally used is five or more.
That describes me. I take six prescription drugs every day. Four of them are directly related to my MS, the fifth is to moderate my cholesterol, and the sixth is to keep my thyroid level where it should be. There’s also a baby aspirin, vitamin D3, and calcium. But who’s counting? It’s probably a good bet that you take as many medications as I do, so we both probably should be counting, because polypharmacy could be particularly troubling for us.
Polypharmacy is usually considered primarily to be a problem for older people. But according to a study recently published by Plus One, “In persons with chronic morbidity such as MS patients, polypharmacy can give rise to considerable health problems.”
The research, from the University of Rostock in Germany, found that 30.3 percent of the 145 relapsing-remitting MS patients who participated were taking five or more meds every day. The average number of meds was 3.6. The most common medication was one of the disease-modifying therapies — nearly 95.9 percent were using one. Dietary supplements were used by 33.8 percent. An analgesic for pain control was used by 29 percent. Strangely, at least to me, only 9 percent were using medications for bladder control and only 6.9 percent used muscle relaxants.
According to a 2017 article on the U.S. Pharmacist website, “Polypharmacy increases the risk of adverse reactions to medications. The more drugs, the higher the risk of drug interactions. Research has shown that patients taking five to nine medications have a 50% chance of an adverse drug interaction, increasing to 100% when they are taking 20 or more medications.”
This can really become a problem when more than one doctor is prescribing medications and when our prescriptions are filled at more than one pharmacy. We all know that too many of our primary care physicians and neurologists have difficulty communicating with each other.
What to do?
The authors of the University of Rostock study write, “For avoiding drug interactions and their clinical consequences, a well thought-out medication management that is based on the optimization of drug use is vital.” They suggest that physicians routinely check to see if “all medications are indeed essential and up-to-date.” They also suggest that doctors consider “non-drug approaches such as physiotherapy” to reduce the use of medications.
But we as patients can also do things to help ourselves. An article on the JAMA Network website lists several ideas. They include:
- Make a list of your medications, including over-the-counter, and review it with all of your physicians.
- Know the purpose of each of your meds.
- Ask your physicians if you might eliminate some of your meds to avoid polypharmacy problems.
How many meds are you on? When was the last time you reviewed all of them with your doctors or pharmacist?
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