It’s easy for a person to forget to take even one multi-vitamin pill each day.
What if you had to take 10 or more medications every day, at certain times throughout the day? Polypharmacy is a term used whenever an individual takes more than one daily medication — either prescription or over-the-counter.
“Most pills are small, round and white these days,” says Bryan Coehrs, ProMedica Pharmacy. “There’s no distinguishing characteristics on many of them, and it can just become overwhelming for our patients. Four to six medications is the line where things typically start to get more complicated.”
That’s why ProMedica Pharmacy offers an adherence pharmacy, which makes it easier for patients to comply with their prescriptions. The pharmacy packages an individual’s medications together, according to administration times: Morning, lunch, dinner, and night.
Helping patients adhere to medications
Open since 2011, the adherence pharmacy’s 800 patients take an average of 10.5 different medications — some may be taken once a day, while others are administered multiple times daily.
That’s a lot of pills.
According to a 2008 report from the United States Centers for Disease Control and Prevention (CDC), prescription drug use is rising. Those taking one or more drugs increased from 43.5 percent of the general population in 2000 to 48.3 percent in 2008, while those using five or more drugs jumped from 6.3 percent to 10.7 percent.
The CDC’s The State of Aging and Health in America 2013 reports 94 percent of adults aged 65 or older take medication for high blood pressure alone. ProMedica Pharmacy utilizes several “tricks” to help patients remember to take their medications.
Besides simply packaging the medications together, staff help people set reminders on their smartphones to administer their prescriptions at the right time of day. Coehrs says some patients prefer a calendar to place on the refrigerator. Alarms may be used to help remind patients to take their pills. Further, some drug manufacturers are making adherence easier by developing more extended-release medications: One pill can release drugs in the body two to three times a day.
Are multiple medications necessary?
Coehrs says polypharmacy, although sometimes complicated for patients, has largely become a “necessary evil” in today’s health care environment.
“As a medical field, we’re so good at diagnosing and spotting chronic disease states early, we have more people in general taking medications than ever,” Coehrs says. “We’ve also realized most of these chronic disease states are multifactorial in the body. So there’s not one thing that’s going wrong that causes you to have diabetes.”
He continues, “Oftentimes, people end up on medications that complement each other because they’re treating different components of the disease states. It is certainly necessary to get these disease states under control. Going after it one way isn’t going to get it done. We’ve done a great job (treating) these disease states but we treat them with so many medications, it’s caused a lot of confusion.”
More medications mean a greater chances of problems, Coehrs says.
“The more drugs you add on top of each other, the more likely you’ll have interactions and side effects,” he says. “Part of the pharmacy industry’s role is to help mitigate those side effects.”
It’s also important to remember that over-the-counter medications must be monitored. “Don’t assume just because you don’t need a prescription, that it’s safe with whatever else you’re taking,” Coehrs says, noting the importance of open communication between a patient and their prescribers and pharmacists.
Coehrs says although a majority of the patients he sees are senior citizens, age isn’t an important factor in adherence to one’s prescription schedule.
“We see people (in their 30s and 40s) who don’t take them because they’re running constantly to take their kids around and they’re like, ‘Oh, I can’t remember to do it,’” Coehrs says. “Very few people don’t take their medications because they just want to be stubborn. We want to make them find a way so it fits into their lifestyle.”