I always fondly look back on my clinical training in London. I believe my readers, patients, and staff all benefit from what I learned there.
Due to the National Health Service (NHS) budgetary restrictions, I learned first-hand that LESS is (usually) MORE.
And I will never forget a response from one of my attending physicians (he was one of many who looked over us youngens’) after I explained the number of medications one of my newly admitted patients was on.
In a very posh, British accent, he said: “If you shake her, you will hear her rattle!”
He was basically telling me that there was no reason for her to be on so many medications. That’s why, to this day, one of the first things I do with my patients is see how many of their medications we can discontinue.
Of course, this is an unusual practice here in the U.S. But a new study shines light on why it’s so vitally important…
Stop before you add
Adults are often prescribed more medication as they age. In fact, one in three older Americans are on inappropriate or harmful prescription drugs.
(Of course, I can now say the same thing for my late generation Y [millennials] and early generation Z patients. They often come to me on the “XY” cocktail, as I call it, for anxiety/depression, an amphetamine to focus, and something to help them sleep. It’s truly mind-boggling to me. But let’s get back to the new study.)
Researchers from RCSI University of Medicine and Health Sciences revealed the importance of analyzing patients’ medications… and eliminating any that may be causing more harm than good.
They looked at the results of the SPPiRE project (supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care), which included 51 general practitioners and 404 older patients in Ireland. Each patient was taking at least 15 different prescription drugs.
Then, participants took part in a medication review by their practitioner to determine:
- If any prescriptions were inappropriate to take together and/or harmful.
- If any drugs could be stopped.
- Which prescriptions should be made a priority.
In the end, among 208 intervention participants, over 800 medications were cut.
Find a doctor that makes time for you
Now, I understand this type of extensive review takes time. Plus, it becomes a challenge when you’re dealing with more than one medical condition and receiving multiple prescriptions from various specialists.
So, if you haven’t already, I first advise finding a general practitioner that will take the time to look at your health holistically and analyze any medication you’re currently on. (When it comes to specialists, many tend to ignore anything other than the health condition that pertains to their area of expertise.)
This is especially important whenever you stop a medication, as you’ll want someone to help monitor the effect that might have on your health. (The same goes for any time you add a medication.)
Then, talk through any questions or concerns you may have—and take as long as you need.
Thankfully, this is simple for me to do with my patients. I’m not rushed because I don’t cram a million patients into my day.
I also make it a rule to go over my patients’ medication list at every vist. Then, whenever I’m considering prescribing something new, the first thing I do is to check for drug-drug interactions. Ask your doctor to do the same.
At the end of the day, polypharmacy is a real problem that mainstream medicine has single-handedly created, with its insistence on doling out prescriptions like candy.
So the next time your doctor whips out the prescription pad, do a double-take before heading out to the pharmacy. Don’t forget to ask about any potential drug interactions or if any other medications can (or should) be stopped. (Always bring a list of all your current medications to any health appointment.)
And remember, it never hurts to get a second opinion.
“Many seniors taking far more prescription drugs than they actually need, study suggests.” Study Finds, 01/07/2022. (studyfinds.org/prescription-drugs-older-patients/)