This month, the Medical Spotlight would like to provide you with information about those changes that occur as we age, what impact these will have on your medication therapy, important facts to know about medications and older patients and tips to prevent these problems.
It is the author’s opinion that your pharmacist can perform the role of ‘patient navigator,’ collaborate with your health care team to manage medications, help you gain an improved level of adherence and have more positive health outcomes.
As we age, our bodies change.
- Some changes we can see and feel: aches and pains may linger while simple movements like walking or getting out of a chair may be slower or more painful than they used to be.
- Some we can’t; our bodies may change in how they respond to and absorb medicines. According to the U.S. Food and Drug Administration and its medication guide for seniors, changes in the digestive system can affect how fast medicines enter the bloodstream.
- Changes in body weight can influence the amount of medicine you need to take and how long it stays in your body.
- The circulation system may slow down, which can affect how fast drugs get to the liver and kidneys.
- The liver and kidneys also may work more slowly. This affects the way a drug breaks down and is removed from the body. Thus, medicines may stay in the body longer causing more severe side effects if doses are not properly adjusted and monitored
- These body changes as we age can create a higher risk of drug interactions in older adults.
Most older Americans (8 out of 10) take at least one medication and many older adults take three or more medications each day. Older adults comprise 13% of the U.S. population, account for 34% of all prescription medicine use and 30% of all over-the-counter (OTC) medicine use.
Medicines & older adults: 10 important facts to know
- Seniors use more medicines—prescription, over-the-counter (OTC) and supplements—than any other age group in the U.S.
- Older adults often use multiple medicines, increasing the risk of drug interactions, mix-ups, and potentially harmful side effects.
- Your liver and kidneys may not work as well as when you were younger. This decreased function affects the way a medicine works, is absorbed, broken down and removed from the body.
- Medicines may stay in the body longer and cause more severe side effects if doses
arenot properly monitored and adjusted.
- Age-related changes in the body such as weight loss decreased body fluid and increased fatty tissue can alter the way drugs are distributed and concentrated in the body.
- Increased sensitivity to many medicines is more common in older adults.
- Impaired memory, hearing and vision loss can make it more difficult to understand/remember medicine instructions, especially for patients with complicated treatment regimens. Many older Americans also face declining eyesight, grip strength, mobility and memory lapses—these can alter a patient’s ability to safely take medication as prescribed.
- Older adults tend to receive prescriptions from different healthcare professionals. This polypharmacy can make it more difficult to track medicines, identify drug interactions, harmful doses, and unnecessary or ineffective medicines. The optimum would be to have one primary provider and pharmacist who can collaborate.
- Chronic conditions such as diabetes, high blood pressure, arthritis, and cancer, are more common in older adults and often require a more complex medical management regimen.
- Older adults may not follow medication plans due to forgetfulness, side effects, feeling the medicine isn’t working, and/or the cost. Not following medication instructions or treatment plans, is called non-adherence.
The good news is, many of these risks or challenges can be prevented if you are armed with information about safe and appropriate medication use and how to get the most from your medications.
& older adults: tips to avoid and prevent problems
- Learn about your health conditions and the medicines prescribed. Talk with your healthcare providers and pharmacist. They can guide you to trustworthy online sites. You can join health support groups. You are your own best advocate when it comes to your health, and knowledge about your own self-care is key.
- Make and maintain a medication list that includes:
- Names of all prescription medications you use. Include OTCs, dietary supplements, and herbal remedies
- The healthcare provider who prescribed each Rx medication
- The purpose of each medication or the symptoms the medication is supposed to treat
- The dose schedule for each. How often and at what dose (amount) each is to be taken
- Whether refills are needed
- Update the list when you start taking something new, a medicine is stopped or if your healthcare professional changes the dosage strength.
- Work with your primary care provider and review all of your medications regularly to make sure you are only taking those you need.
- Remind him or her of any allergies or problems you’ve had with certain medicines. Don’t stop taking prescribed medicine without checking with him/her first.
- Be sure to read the Drug Facts label (found on all OTC packages), package inserts or Patient Medicine Information leaflets (provided with your prescription medicine(s)) when starting a new medication. These can provide important information to help you get the best results and avoid problems. These tell you:
- What your medicine is used for
- How to take your medicine correctly (how often you should take it and at what amount or dosage)
- Possible side effects or allergic reactions to
- Warnings including who shouldn’t take the medicine, when to stop use and ask a doctor, who is at increased risks of side effects
- Storage instructions
- Use one pharmacy so that your prescription records are all in one place. This enables your pharmacist to regularly monitor the medications you take and let you know about potential drug-related problems such as side effects or drug interactions.
- Safely store medicines. Check expiration dates. Keep all medications in the bottle, box or tube that they came in so the dosage and directions are always close at hand. Keep medicines up and away and out of sight of pets and when grandchildren come to visit. Never share your prescription medicines or take others’ medications. (Visit our medicine storage and disposal page for more information.)
- Contact your healthcare provider and pharmacist if you have any problems with your medicine. There are no “stupid questions” and no question is too trivial when it comes to your health and your medicines.
- Identify a “patient navigator” within your healthcare team to navigate the healthcare system and take prescription medicines as prescribed. This is especially important when older adults suffer from multiple chronic conditions. Ask your primary care physician or pharmacist to advocate, or “navigator” through the health system. That way, one person or practice is responsible for ensuring that all of your chronic conditions and treatment regimens are being tracked and addressed. Under Medicare’s Medication Therapy Management (MTM) Program, pharmacists or other healthcare professionals can fulfill this patient navigation role. Consider this option as well.
- Aging + Alcohol + Prescription medications = Health risk: Drinking alcohol when you are taking a prescription medication is a health risk for many and older adults. Aging bodies work more slowly to clear both medications and alcohol, which makes seniors more sensitive to the effects of both. Many prescription medications may interact with alcohol and cause potentially dangerous adverse effects. Prescription medications may not work as intended when combined with alcohol; may not work at all, or, they may become harmful–even toxic. If you have certain health conditions or take certain medications, you may need to drink less or not at all. Ask your health care professional for guidance.