Prime Time Living 6.14.26 - Flipbook - Page 16
16
| Sunday, June 14, 2026
HEALTH
Polypharmacy:
Modifying Medication
Overload
Be your own advocate by
examining what you are
being prescribed
By Margit B. Weisgal, Contributing Writer
O
ne in ten hospital admissions in older adults are the result of a medication side
effect. And one in six adults age 65 or older will have at least one side effect
from their medicines, according to PLOS, a nonprofit 501(c)(3) corporation.
Galen Lucas was meeting Dr. Marc
Kai, M.D., Ph.D., his new primary care
physician (PCP) at Mercy Medical
Center. A little nervous, he sat, fidgeting
in the exam room, when the doctor’s
assistant entered, and he sat up, now
alert.
After the physician’s assistant (P.A.)
introduced herself, she addressed
Lucas. “We received your records from
your previous doctor. I’d like to review
your medication list.”
“OK,” Lucas replied, and proceeded
to nod after each name she read out.
When that was over, she thanked Lucas
and left the room.
Within seconds, Dr. Kai entered, welcomed him, and started reviewing his
medical history, confirming which diagnoses were current along with the medications to address each one.
“Let’s see if we can modify or eliminate some of the medications you’re
taking,” Dr. Kai said, aware that many
medications have side effects that are
tempered by adding additional medications.
According to the U.S. Centers for
Disease Control and Prevention (https://
cdc.gov/), in a study that looked at medication usage from 2017-March 2020,
the percentage of people taking five or
more prescription drugs in the past 30
days increased for adults age 65 and
older, from 33.3 percent to 43.0 percent.
Medication Overload and Other
Definitions
“Polypharmacy is using multiple prescription drugs,” according to an article
by Johns Hopkins Medicine on its website. The National Library of Medicine
published an article on definitions and
consequences of polypharmacy in older
adults. It says, “143 definitions of polypharmacy and associated terms were
found. Most of them are numerical definitions. Regardless of the definition,
polypharmacy is highly prevalent in older
adults, particularly in nursing home residents and hospitalized patients.”
In other words, with age, we tend
to have more medical issues and take
more medications. What we should not
do is take more than we need or for
longer than we need them. And it is the
numbers of meds that cause problems.
Someone needs to oversee the complete list and make sure they don’t have
dangerous interactions when taken at
the same time, or that they can cause
issues on their own.
How many is too many? In addition to
those prescribed by your various physicians, when reviewing your medications
with your PCP, you should include any
over the counter (OTC) supplements of
nutrients and vitamins and herbs you
added yourself or on advice of a friend.
How Polypharmacy Happens
Picture this: you’re taking prescription
medicines and vitamins and herbs and
supplements all in one day. Some are
before a meal, some after, some before
bed. Did you read the insert that came
with the medication(s) about how to
take it/them and any contraindications
(when that particular drug is inadvisable)? And if you’re taking supplements,
when should you take those? And is
there a warning on the label (which
you never noticed before) that says
don’t take this if you’re already taking
something else? This is exactly how
polypharmacy happens.
Someone needs to be your traffic
manager. You have two choices: your
primary care physician or your pharmacist. Or both!
“There are two schools of thought,”
explains Dr. Kai. “You can be a maximalist or a minimalist. I am the latter. I want
a plan, a purpose, for why I make specific choices and how we will address
each issue. When there are overlapping
problems, I want to prescribe the smallest possible minimum effective dose.
Depending on how many coexisting
conditions we are working on, we, my
patient and I, will review the status
either once or twice a year. And, yes,
I’ve had patients come to an appointment carrying a bag (or a pillowcase)
of all the pills they have in the medicine
cabinet and kitchen.
