You notice from my blog title, which is same as the Medscape article “How Chronic Is Polypharmacy in Old Age?” they are not asking IF there is polypharmacy in old age, they are asking HOW MUCH. Polypharmacy in the elderly is entrenched and has become a topic of research. I think the funding of the study would have been better spent to distribute ReMag to these folks to help them with magnesium deficiency conditions and to lower their drug intake.
The study followed 711,432 adults, aged 65 years and older, who were on five or more prescription drugs. The duration of the study was from Oct 2010 until Dec 2013. The median age was 77 years, 59% were women, and 7% lived in nursing homes.
An incredible 82% were continuously exposed to polypharmacy for 6 months or longer, and 74% for 12 months or longer. The proportion of individuals who remained exposed from start to finish was 55%. Factors associated with chronic polypharmacy included higher age, female sex, living in an institution, chronic multimorbidity, and multidose dispensing.
How does this happen?
I was exposed to polypharmacy during my internship at Mt. Sinai in Toronto. I was on a live-in geriatric rotation at a nursing home/hospital with time to spare at night. I decided to study the patients’ charts where I found polypharmacy before I even knew it was a “thing.” I was shocked to find that every patient was taking copious amounts of medications. Orders were written into the chart when any new symptom came along without regard for previous prescriptions, overdosing, or contraindications. The time was 1978, before computers, so I created a paper flow chart for each patient listing their meds, prescription date, and my notes on why they were no longer needed, contraindicated, or redundant. I saw ridiculous prescribing patterns such as a drug to increase bowel movements along with a drug for diarrhea!! Unbelievable!
I presented each chart to the doctor of record as if it were an intern project. Most of them accepted the information but seemed surprised that their patients were on so many meds – although they had written the orders.
What was the conclusion of the Polypharmacy study? “Polypharmacy is most often chronic, although a substantial share of older adults experience short, recurring episodes of polypharmacy and are thus exposed to its potential harms in a transient rather than persistent manner.”
Did they have any recommendations? Nope, not a one! Medicine gave up on polypharmacy long ago. In their preamble, the researchers said “various interventions have been implemented to reduce the prevalence and the harms of polypharmacy. Most of these interventions have proven unsuccessful.” So they don’t bother anymore and will just keep getting funding to track the problem. Their last statement doesn’t even encourage doctors to cut back on meds for the elderly. They say: “This highlights the need to consider polypharmacy as a dynamic state in both epidemiological studies and in clinical practice.”
The focus of a good gerontologist is to take patients off unnecessary medications. It would be even better if gerontologists knew about ReMag so they could treat magnesium deficiency and uncover misdiagnosed diseases.
What can we do about this threat of polypharmacy?
- Know that polypharmacy exists and should be avoided.
- Only take medications when absolutely necessary and for as short a time as possible.
- Know that your body has the ability to create perfect cells.
- Use the Completement Formulas as the building blocks for perfect cells, a healthy body and to avoid medications and hospitalization.
- In the case of the elderly in an institutional setting – offer ReMag Lotion in a empty body cream jar for body wide application.
- For anyone who can take supplements – use the Completement Formulas.
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Carolyn Dean MD ND
The Doctor of the Future®
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