Here’s what we know: some people take “Lots of medication”. Recently, the Canadian Institute for Health Information published a report using statistics from 2016. Approximately one third (35.3%) of seniors used 5 or more chronic medications, and 1 in 18 seniors use 10 or more drug classes every day.
The report showed that as we increase in age, the number of medications used also increases. While this review did not specify exactly why this happens, there are some logical explanations for this (see figure).
Let’s focus on two of the contributors that lead to “lots of medication” – side effects and misdiagnosis. These combined can cause an event called a prescribing cascade.
A prescribing cascade can happen when a patient presents to their doctor with a new complaint such as a cough or diarrhea. Instead of considering it to be a side effect of their medication, a prescription is written to treat the new condition (a misdiagnosis).
Here is an example:
- You have some back pain, so you are prescribed an anti-inflammatory (naproxen) to help
- on the next 2 visits your blood pressure is high. Amlodipine is prescribed
- the next visit you complain of swollen ankles. You receive a prescription for furosemide (a water pill)
- next visit your blood work shows your potassium is too low. You leave with a prescription to start potassium chloride pills
Let’s review what happened:
- Anti-inflammatories can increase blood pressure
- Amlodipine has a side effect of leg swelling
- Furosemide lowers potassium levels
So ultimately, your back pain has now led to 4 prescriptions. Yikes!
What is a solution?
Become informed! Take the time to visit or call your pharmacist to discuss new symptoms. You might be surprised to find a connection with your medication. And guess what? Both new medications and medications you have been using for a long time can cause new symptoms or problems! Stay tuned for more information on this interesting topic.
