Managing Medications

A major problem with medical treatment for the elderly is the large number of prescription medications the average older person is taking. On average, a person over age 75 has five prescription drug medications and is using at least two over-the-counter medications as well as taking herbal supplements.

Many older patients continue prescriptions with a number of doctors and specialists and no one doctor, not even the primary care physician, often knows the number or extent of medications being taken. It is not surprising to see the large number of adverse drug reactions and hospitalizations and deaths due to drug reactions among the elderly.

In order to control the problem with an older person taking multiple prescriptions from many doctors, the older person or a responsible family member should bring all medications being taken by the patient to a doctor's appointment. This definitely includes all herbal supplements and over-the-counter medications as well.

It is useful to go over with the doctor what each medication is for. If there is no reason to take that medication or if it may be causing interaction the doctor should indicate that and should withdraw the prescription. As a general rule, the more the medications, the more the potential for problems. A concerted effort should be made by the physician to prescribe the fewest medications possible to control a medical problem.

One way to combat the problem with an older person who is not complying with taking pills at the proper time or not taking enough or taking too many is to use the popular "pill calendar box."  Many people have already adopted this idea but for those who haven't this is an extremely effective way to administer medications.

Many people order their medications through the mail and some may even obtain prescriptions on the Internet. Internet prescriptions might be a common practice for very popular medications such as Phetermine or Viagra. For the elderly this may not be a good practice.

It is recommended that all medications be ordered through one pharmacist, particularly a pharmacist that has a certification in geriatric pharmacy. By controlling all medications through one database, the pharmacist can alert the older person or his or her family about a possible drug interaction or adverse drug reaction.

This central database approach should become much easier for those older people who enroll under the Medicare Part D drug program. Presumably the company offering the drug benefit will have a database for its insured