How Many Medications Do You Take?
By Sandra Ogata, MD, board-certified in family practice with Parrish Medical Group.
As a family practice specialist, I see patients who have a variety of health issues: acute (cold, flu, infection), chronic, serious and unidentified (or underdiagnosed).
Q. What problem do you see that concerns you most?
A patient may be taking multiple medications—for diabetes, hypertension, heart disease, depression, chronic pain, thyroid disease—prescribed by many different physicians and specialists. Each prescribes a different medication for a specific condition.
Q. Why is this such a big problem?
The risk of adverse drug reaction in patients 65 years and older increases by 13 percent with two medications, 58 percent with five medications, and 82 percent with seven or more medications prescribed. Adverse drug events are responsible for more than 100,000 hospitalizations per year among seniors. The Institute of Medicine estimates that 1.5 million preventable adverse drug reactions occur every year in the U.S.
Q. Doesn’t modern medicine help us live healthier lives?
Absolutely. But when a person uses multiple medications, often called polypharmacy, it can cause problems if some of them interact negatively with others. A person’s age and ethnicity and genetic variations (DNA) can affect how drugs are metabolized.
Q. What can people do to help prevent this situation?
Patients should have one primary care physician to coordinate all their prescriptions among different specialists. I follow strict guidelines when checking for drug interactions (e.g., the Beers Criteria from the American Geriatrics Society).
I also use a genetic test that analyses the liver enzyme genetic code that metabolizes more than 90 percent of the medications prescribed. It is a simple mouth swab done in my office, which is covered by insurance, and I have the results in less than two weeks. I have helped my patients with countless adverse side effects, such as dizziness, rash, anxiety, uncontrolled high blood pressure and high blood sugar, depression and insomnia. I can personalize a patient’s medication according to his or her genetic code, so the chance of side effects decreases, along with the number of different prescriptions used to control the same disease.
Q. What’s the best way to ensure a person’s physicians know about all the medications?
I always ask my patients to bring all their medicine bottles to every appointment. This is the best way to avoid overdose. Patients tend to know the color and shape of their pills or tablets, but doctors know the drug names. Telling your doctor that you take one blue pill a day and a small yellow pill at night doesn’t help him or her confirm whether you are taking the prescribed medication correctly. By Sandra Ogata, MD
Sandra Ogata, MD, is board-certified in family practice with Parrish Medical Group. Her office is at 702 Country Club Drive, Titusville. Call 321-268-1995 for free advice and an appointment.