Many
elderly friends suffer from multiple chronic diseases such as hypertension,
diabetes, and cardiovascular diseases. They take a variety of medications daily
and often take them all at once for convenience.
Many people believe that taking multiple medications simultaneously can better control their condition, but they overlook the risks associated with drug interactions, liver and kidney damage, and increased adverse reactions caused by drug accumulation.
Dr. Zhang Zhao, a Deputy Chief Physician in the Geriatrics Department of Hainan Chengmei Hospital, stated that polypharmacy is not simply the addition of medications, and only standardized medication use can ensure the safety of elderly patients.
What is polypharmacy?
Clinically, the simultaneous use of five or more medications is generally defined as polypharmacy, encompassing prescription drugs, traditional Chinese patent medicines and simple preparations, health products, topical preparations, etc.
Dr. Zhang Zhao reminds that due to the physiological decline in liver and kidney function, as well as the reduced ability to metabolize and eliminate drugs, elderly individuals are more prone to drug accumulation, and the safety risks associated with polypharmacy are significantly higher than those faced by the general population.
Avoid these common medication misconceptions!
Self-medication: When experiencing fluctuations in blood pressure or blood sugar, arbitrarily increasing the dosage or combining medications with similar effects;
Following the trend in medication: Upon hearing that others have had good results from a certain medication, one purchases and takes the same medication without proper consultation or evaluation;
Confusing health products with drugs: Long-term use of health products that promote blood circulation and calm the nerves, without actively informing the doctor during a visit;
Double the dose for missed dose: To compensate for the missed dose, take a double dose all at once next time.
When administering multiple medications to the elderly, it is important to adhere to five core principles
01 The principle of minimizing medication and prioritizing simplification should be followed. The primary principle for elderly medication is that the benefits should outweigh the risks.
When seeking medical treatment, elderly patients should proactively present all their medications. Doctors will give priority to selecting medications with multiple effects and minimal interactions, promptly evaluate and discontinue non-essential and auxiliary medications, and advise against long-term medication without indications.
02
Organize the medication list and proactively inform the patient during the
consultation. It is recommended for family members to assist the elderly in
creating a medication list, specifying the drug name, dosage, and time of
administration.
Dr. Zhang Zhao reminds patients that whether it's for follow-up appointments in specialized departments or emergency visits, they should always bring a list with them, and should not conceal health supplements, medicinal patches, or folk remedies. When visiting multiple departments, it is convenient for doctors to conduct a comprehensive assessment and avoid drug conflicts.
03 Distinguish the timing of medication intake. Some medications may interfere with each other's absorption when taken all at once, so they need to be taken at intervals.
For example, gastric mucosal protectants, iron supplements, and some antibiotics need to be taken at staggered times; most sustained-release and enteric-coated preparations are strictly prohibited from being broken or crushed before taking; a few scored sustained-release tablets can only be broken along the score strictly according to the instructions, and must not be crushed or chewed. Dr. Zhang Zhao reminds that patients should strictly follow the doctor's advice to distinguish between taking medication before meals and after meals, and should not take all at once to save trouble.
04 Regularly review and assess, dynamically adjust the plan. Chronic disease treatment plans are not static.
Dr. Zhang Zhao suggests that elderly patients with multiple medications should have follow-up visits every 3-6 months, and medication adjustments should be made based on changes in liver and kidney function and various indicators. If the elderly experience decreased appetite, weight changes, or cold infections, they should also seek timely follow-up visits for evaluation, rather than taking medication all year round without ever reviewing their condition.
05 Pay attention to abnormal signals and seek medical attention promptly. If you experience symptoms such as dizziness, fatigue, nausea, poor appetite, rash, abnormal bleeding, unsteady walking, or confusion during the medication period, do not hold back.
Dr. Zhang Zhao advises that patients should temporarily discontinue any suspicious medications and seek medical attention at the geriatrics department or the relevant department as soon as possible to investigate any potential adverse drug reactions.
Dr. Zhang Zhao specifically reminds that elderly people may have memory loss, making them prone to missing or taking the wrong medication. They can use pill compartment boxes and set reminders with alarms; family members should not decide to increase or decrease medication on their own, nor should they randomly purchase unverified remedies or "special drugs" from online.
In the management of chronic diseases in the elderly, safety takes precedence over polypharmacy. The core of polypharmacy management lies in using the fewest and most appropriate medications to stably control the condition under professional evaluation, thereby minimizing the harm caused by medications.
(Friendly reminder: This article is for health education purposes and cannot replace a doctor's in-person consultation and prescription. Please follow your doctor's advice for any medication adjustments.)