According to the Centers for Disease Control and Prevention (CDC), nearly 41 percent of older Americans (age 65 years and over) take five or more prescription drugs in a given 30-day period. These medications are often prescribed by multiple doctors, which poses serious oversight issues. It’s no surprise that polypharmacy (taking multiple prescriptions, some of which may not be necessary) and medication non-adherence (failing to follow prescribing instructions) are two major problems among the aging population.
Medication issues may seem minor compared to common age-related conditions like heart disease, dementia and cancer, but non-adherence alone causes an estimated 125,000 avoidable deaths each year. According to Mindy Smith, executive director of the American Pharmacists Association (APhA) Foundation, non-adherence contributes to as much as 25 percent of admissions to hospitals and nursing homes. “It can lead to disease complications, reduced quality of life, increased medical costs and unnecessary medication changes,” Smith notes.
Why Seniors Don’t Take Their Medications As Directed
There are several reasons why an older adult may intentionally or unintentionally fail to take their medications as prescribed. Visual impairment, whether caused by disease or age-related vision loss, can prevent a person from reading the instructions on a prescription bottle or make it difficult to distinguish between pills that look similar. Cognitive issues, such as memory loss and confusion, can compromise one’s ability to follow even the simplest medication regimen. Sometimes older adults may have trouble physically swallowing large pills. But beyond physical and cognitive limitations, some seniors will discontinue their medications or take them sporadically because they dislike the side effects they cause or because they struggle to pay rising prescription drug costs.
Use Your Pharmacist As a Resource
Addressing these multifaceted barriers to medication adherence can be difficult, especially when a senior sees several different doctors. Hospitalizations typically add to a senior’s care plan and medication regimen as well, at least temporarily. Open and accurate communication about prescription drugs, over-the-counter medications, vitamins and supplements with all physicians on a senior’s care team is paramount, but this is often easier said than done. Yet, there is one more healthcare professional on your loved one’s care team who can help: their pharmacist.
The pharmacist who dispenses a senior’s prescription medications is an important resource for preventing polypharmacy and non-adherence. Using only one pharmacy to fill all a senior’s prescriptions may not always be the most cost-effective option, but doing so increases the pharmacist’s ability to screen for medication interactions and suggest useful management techniques.
“Pharmacists have expert knowledge in medication therapies and can help patients understand how their medications treat their condition,” explains Smith. Physicians and pharmacists can also work together to help a patient manage their medications, so long as the lines of communication between doctor, patient, caregiver and pharmacist are kept open.
Services Pharmacists Offer
A pharmacist’s job entails more than simply filling prescriptions. They spend years studying drug chemistry and how medications affect the body. In addition to providing vaccinations and helping customers navigate insurance coverage, pharmacists can be your ally in helping an aging loved one manage all aspects of their pharmaceutical therapy.
General Medication Counseling
Pharmacists are always available to answer questions about prescription and over-the-counter (OTC) medications, whether they pertain to side effects, costs, savings programs, interactions, organization methods or dosing instructions. Free consultations on all of these topics are meant to help increase patients’ medication adherence and minimize polypharmacy.
Countless seniors and family caregivers struggle with constant runs to the pharmacy to fill and pick up multiple prescriptions. To better streamline this process, thousands of pharmacies nationwide offer “medication synchronization” programs. These programs enable patients to schedule monthly appointments with their pharmacists so they can pick up their medications in fewer visits. Of course, patients can receive in-depth medication counseling on these scheduled visits as well. Consumers can ask their pharmacists about med sync programs or visit the APhA Foundation website to search their directory for local pharmacies that provide this service.
Brown Bag Check-Ups
The so-called “brown bag check-up” involves bringing all one’s medications, vitamins and supplements to the pharmacist and having them check to see if there are any possible interactions or negative synergistic effects between these substances. Most pharmacies allow patients to schedule appointments for a brown bag check-up. It’s advised that a person make one of these appointments at least annually, especially if they are taking several maintenance medications for one or more chronic conditions.
Advice on How to Take Medications
While prescribing information can be tailored to a person’s unique needs, initial instructions tend to be one-size-fits all. Physicians do their best to prescribe drugs accurately, but there is often some degree of trial and error involved in finding what works best. The truth is that people can react very differently to the same dose of the same medication. Seniors in particular metabolize powerful prescription drugs very differently than younger individuals and may be more likely to experience adverse side effects.
While they can’t make drastic changes to a physician’s prescribing orders, pharmacists can suggest that a patient modify the way they take a medication to minimize side effects like heartburn or drowsiness and better control symptoms of their chronic disease(s). For example, certain medications like steroids can cause wakefulness. If a senior is having difficulty sleeping, then their pharmacist may suggest timing the prescribed doses a little differently to help improve their chances of getting a better night’s rest.
Pharmacists can also contact prescribing physicians to discuss alternative drug options or administration methods that may better fit a senior’s needs and improve adherence. Questions a caregiver might ask a pharmacist about their love one’s medications include:
- How often should my loved one be taking this medication?
- Should they take this medication on an empty stomach, with water or with food?
- What are some warning signs that this medication may not be working as intended?
- What side effects should I look out for while my loved one is on this medication?
- Is there anything I can do to prevent or minimize the side effects they experience?
- Are there any foods, beverages or other medications that they shouldn’t have while on this prescription?
Family caregivers must be forthcoming about any questions or concerns they have regarding a loved one’s health and care plan. Pharmacists usually aren’t viewed as members of a senior’s care team, but they can be very helpful in simplifying medication management.
Sources: Health, United States, 2017 (https://www.cdc.gov/nchs/data/hus/2017/079.pdf)