Do I Have to Visit Doctor Again for Prescription

Many seniors take multiple drugs, which can lead to side effects like defoliation, lightheadedness and difficulty sleeping. Doctors who specialize in the intendance of the elderly oft recommend carefully reducing the medication load. Juanmonino/Getty Images hide explanation

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Juanmonino/Getty Images

Many seniors take multiple drugs, which can lead to side furnishings like defoliation, lightheadedness and difficulty sleeping. Doctors who specialize in the care of the elderly often recommend carefully reducing the medication load.

Juanmonino/Getty Images

It's a mutual problem for many older adults. You may have more than than one md and each prescribes a different drug for a unlike illness. Before y'all know it, you're taking multiple medications and commencement feeling tired, silly or nauseous. Your medico interprets that equally a new symptom for a new disease and prescribes withal another drug.

Overmedication is a wellness hazard for older adults that their doctors can oft overlook. "Information technology'due south easier for doctors to just start some other medication than it is for them to evaluate each [current] medication," says Leah Rorvig, a geriatrician and an assistant professor of medicine at the University of California, San Francisco.

The problem is that we become increasingly sensitive to the side effects of drugs as we age, says Rorvig. For instance, older adults are sometimes prescribed a drug class known as proton pump inhibitors to treat heartburn. Rorvig explains that this blazon of medication can cause weakening of the bones, which puts older people at a higher run a risk for falls and fractures.

Almost a third of American adults aged 60-79 used five or more prescription drugs in the past xxx days, according to an August report past the Centers for Disease Control and Prevention.

And the more than prescription drugs you take, the college your risk for agin reactions, says Michael Steinman, a geriatrician and professor of medicine at the University of California, San Francisco.

These include unexplained symptoms such as diarrhea, constipation, lightheadedness, weight loss, nausea, confusion, difficulty sleeping or sleeping too much, Steinman says.

"This does non guarantee that any of the symptoms are due to [a detail] medication. But if you don't consider it, oftentimes this won't be recognized," he adds.

And some of these symptoms increase the hazard of falls, which contribute to a growing number of deaths among the elderly.

Although some older adults really do demand to accept multiple prescription drugs, this is not always the instance. That's why some clinicians who piece of work with the elderly advise they consider deprescribing — reducing the dose of medications that might be causing damage or stopping them altogether under the guidance of a doctor.

Family members of elderly adults may want to keep an eye on their prescriptions, says Barbara Farrell, a pharmacist and clinical scientist with the Bruyère Research Institute in Ontario, Canada, who co-leads a project that publishes deprescribing guidelines for the elderly. A good time to talk to your loved one's doctor about possibly eliminating some meds is when you notice a meaning change in their health. For example, accept non if they suddenly become frailer or are diagnosed with a serious illness. If they start skipping medications or hiding pills, that's also a alarm sign, Farrell says.

But reviewing prescriptions is non simply about stopping them, says Steinman. "We're actually optimizing medications, stopping those that are causing harm, simply also recognizing if there's annihilation missing that nosotros should think virtually prescribing that's going to exist helpful," he says.

Preliminary inquiry shows that deprescribing might reduce cognitive decline as well as referrals to astute care facilities and mortality. Anecdotally, Farrell says, she sees her patients' quality of life improve when she stops certain medications.

Here are some simple ways yous tin can assess and manage your prescription drug employ— or help a loved 1 practice and so — including talking to your doctor to observe out if deprescribing is the right move.

Schedule a dr. visit to review medications

"One of the reasons why people let these problems linger is that when people become to their doctor, the visits often revolve around a medical problem," says Steinman. Schedule a physician visit to specifically go over your medications. Ask questions about what each prescribed drug is for and whether there are any that are not necessary. You should besides talk nearly any new symptoms and ask whether drugs could exist causing them.

For people over lxxx, it's a skillful idea to review all medications one time a year, says Farrell.

Know which meds you are taking and why

To ready for meeting with your physician, Farrell recommends making a chart with one column for each of the following: the drug name, the reason for taking information technology, who prescribed it, when they started taking it, whether it's working and the side effects. She suggests making a chart for each medication type. For case, i nautical chart for diabetes medications, and another one for all pain medications.

"This helps doctors meet the big picture show for each condition very quickly," she says.

Yous as well want to make sure y'all know how long you lot're supposed to be taking medications. Some are just meant to solve short-term problems.

Plan on multiple doc's visits to safely reduce your medication load

Deprescribing requires some commitment from the patient to follow a plan, says Rorvig. In her practice, she commonly stops one medication at a time to encounter how the patient responds. If the response is positive, this might signal the patient did non need the drug. All of this requires ongoing dr. appointments every two to three months.

Talk over your treatment goals and preferences

"Sometimes I call back people presume that their doctor knows their preferences. Don't assume that," Farrell says. For example, she had a 93-yr erstwhile patient who wanted to exist able to walk across the soccer field so that he could spotter his grandkids play soccer, but he couldn't because his cholesterol-lowering drug made his legs sore. "Nosotros stopped his cholesterol-lowering drug — we helped him with some forcefulness exercises, and his pain went away. He was able to walk and he was thrilled," Farrell says.

Consider nondrug strategies

Treatments other than drugs are a adept alternative for some weather condition. For example, Farrell says to consider switching to decaf coffee instead of taking sleeping pills, which might cause drowsiness and increase the risk of falls. Cognitive behavioral therapy might be more effective and rubber for treating insomnia than taking a drug. Farrell besides recommends using walkers to minimize knee and hip pain and reduce dependence on pain medications.

Keep your doctor in the loop

Make certain your medico knows when yous start a new drug, who prescribed it and why, says Farrell. This is important if you're receiving prescriptions from a doctor other than the family medico, such as a specialist or an emergency intendance doctor. "Often information technology'south up to the patient to keep track of that information and communicate information technology to the dissimilar prescribers," she says. Speak up if you lot're not seeing the benefits of a new medication.

Be smart about adding to your prescriptions

If a doctor suggests a new medication, Rorvig recommends checking the Beers list, a publication of the American Geriatrics Club that lists the medications that are potentially inappropriate for about older adults.

Farrell recommends turning to your pharmacist for advice about the potential for drug interactions and agin symptoms. They tin too help you ready questions for your doctor and inform decisions about which drugs might be adept to eliminate. "I think something that'due south a bit unique to pharmacists is that nosotros're trained to place the side effects of drugs," she says.

See a geriatrician

Rorvig suggests older patients encounter a geriatrician rather than a primary care doctor. "Geriatricians will be merely more than equipped to assistance with the specific medical bug of an older adult," she says. She recommends this especially for older patients who have multiple health conditions. "A geriatrician will automatically review all of your meds and start taking away things that they don't think volition exist of benefit," she says.

Luisa Torres is an AAAS Mass Media Boyfriend on NPR's science desk. She's on Twitter @luisatorresduq .

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Source: https://www.npr.org/sections/health-shots/2019/08/15/751272016/do-you-need-all-those-meds-how-to-talk-to-your-doctor-about-cutting-back

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