Are Seniors Taking Too Many Medications?

Written by Dr. Steve Chaney on . Posted in Medications

The Dangers of Polypharmacy

Author: Dr. Stephen Chaney

 

seniors taking too much medicationModern medicines are truly miraculous. They control the  symptoms associated with many major diseases. At their best they  save lives. But have we become too reliant on medications to cure  everything that ails us?

Every medication has side effects, and many medications interact  with each other in harmful ways. That has become a major concern for our senior citizens because many of them end up on 5 or more medications, something the  medical profession refers to as polypharmacy.

Why Are Seniors Taking So Many Medications?

It starts innocently enough:

  • antioxidant aging Your cholesterol edges up a bit, and your physician recommends  that you go on a statin to reduce your risk of a heart attack. This  is in spite of the fact that it has been almost impossible to prove  that statins actually decrease heart attack risk in people who  have not yet had a heart attack (See “Do Statins Really Work?”  (https://healthtipsfromtheprofessor.com/cholesterol‐lowering‐ drugs‐right/) and “Does An Apple A Day Keep Statins Away?”  (https://healthtipsfromtheprofessor.com/apple‐day‐keep‐statins‐ away/))
  •  Sometimes your cholesterol may not even be elevated. In today’s world statins are often recommended if you are over a certain  age, are overweight, and have some other risk factor such as pre‐ diabetes or high blood pressure.
  •  Your blood pressure starts to inch up (something that happens to most people as they get  older), and your physician recommends one or two blood pressure medications.
  •  Your blood sugar gets a bit high, and your physician recommends a drug to control your  blood sugar to prevent your pre‐diabetes from turning into diabetes.
  •  Perhaps you develop a minor arrhythmia (something else that often happens as we get  older), and your physician recommends one drug to control your heart’s rhythm and  another drug to thin your blood.

Before you know it you are on several medications. As if that weren’t bad enough, each of these  medications has side effects, so you often need to add other medications to control the side effects  of the original medications. For example:

  •  Perhaps you develop heartburn, gas, and/or bloating from the statin, so your physician recommends a drug to control those side effects.
  •  Perhaps you develop headaches, depression, or g.i. symptoms from your blood pressure medication, and your physician gives you one or more drugs to control those symptoms.

I could go on, but I think you get the point. It is easy for senior citizens to end up on multiple  medications. The question is whether that is a good thing or a bad thing.

Are Seniors Taking Too Many Medications?

are supplements dangerousA recent study (Qato et al, JAMA Internal Medicine,  doi:10.1001/jamainternmed.2015.8581, published online March 21, 2016) shows just how big a problem this has  become. The authors conducted a longitudinal, nationally  representative sampling of community‐dwelling adults  aged 62 to 85 years old. They conducted in‐home  interviews that included medication inspections with  2351 participants in 2005‐2006 and again with another  2206 participants 5 years later in 2010‐2011.  The results were startling:

  •  Simultaneous use of at least 5 prescription medications increased from 30.6% in 2005‐ 2006 to 35.8% in 2010‐2011.   That is a 17% increase in just 5 years!
  •  The percentage of adults using medication combinations with the potential for major drug‐ drug interactions increased from 8.4% in 2005‐2006 to 15.1% in 2010‐2011.   That’s almost double in just the last 5 years! To put that into perspective, it means that almost 1 out of every 6 seniors in this  country is at risk of major drug‐drug interactions.
  •  Most of those dangerous interactions were due to physician prescribed medications,  although interactions with over the counter medications also contributed to the total.

The authors of the study concluded “These findings suggest that unsafe use of multiple  medications is a growing public health problem.”

The Most Dangerous Drug­-Drug Interactions

The problem is that these drug‐drug interactions aren’t minor  inconveniences. They can kill you. Here are some of the more  dangerous drug‐drug interactions the authors listed:  Let’s start with those drug‐drug interactions for physician‐ prescribed medication.

  •  Statins used in combination with some blood pressure  medications or with Coumadin can lead to excessive  bleeding, muscle damage and kidney failure.
  •  The combination of those same blood pressure medications with anti‐platelet blood  thinning medications like Plavix dramatically increases the risk of a heart attack and death.

DangerAnd, it’s not just interactions of physician‐prescribed drugs that are of concern. Interactions  between physician‐prescribed drugs and over the counter medications can be equally dangerous.

These interactions are particularly insidious because patients often don’t tell their doctors about  over the counter medications they are using. For example:

  •  The combination of blood thinners with pain relievers such as aspirin or Aleve generally  leads to excessive bleeding.
  •  However, the combination of certain anti‐platelet blood thinning medications such as  Plavix and either pain medications like Aleve or acid reflux medications like Prilosec can  have the opposite effect – causing blot clot formation (such as deep vein thrombosis)  which can lead to heart attacks and cardiovascular death.

Is There a Better Way?

age-related muscle lossIn an editorial that accompanied this study (JAMA Internal  Medicine, doi:10.1001/jamainternalmedicine.2015.8597)  Dr. Michael A, Steinman said “There are many older adults  who would be healthier if they threw away half of their  medications. Yet, there are people with multiple chronic  diseases who can benefit from multidrug therapy…We  [currently] do not have methods that allow us to reliably  evaluate medication therapy…for the outcomes that really  matter, namely whether a drug is actually helping the  patient, causing adverse effects, or is necessary at all.”

If your doctor doesn’t really know for sure whether the medications you are taking help you, hurt you, or have no effect, you might be wondering whether  there is a better way. The answer is a clear YES!

  •  Multiple studies have shown that lifestyle change is more effective than medications for  keeping blood pressure under control (for example: Guzman‐Castillo et al, BMJ Open,  doi:10.1136/bmjopen‐2014‐006070).
  •  Studies have also shown that lifestyle change is more effective than medications for  controlling diabetes (for example: Knowler et al, New England Journal of Medicine, 346:  393‐403, 2002).
  •  The evidence for heart disease is so strong that both the National Institutes of Health and  the American Heart Association recommend that a little TLC (Therapeutic Lifestyle  Change) be tried before resorting to statins and other medications to lower cholesterol and reduce heart attack risk (http://www.nhlbi.nih.gov/health/resources/heart/cholesterol‐ tlc).

Fortunately, you don’t need different lifestyle changes for different diseases. One size fits all!  I  have talked about a healthy lifestyle in great detail in past issues of “Health Tips From the  Professor.”  In brief, a healthy lifestyle consists of a  mostly plant‐based diet with healthy fats, healthy carbohydrates, and healthy proteins. Then add  in exercise, weight control, and appropriate supplementation and you have a winning  combination.

Why risk the dangers of multiple medications when there is a better way?

The Bottom Line

  1.  A recent study has clearly demonstrated that the use of multiple medications in senior  citizens aged 62 and older is starting to reach dangerous levels. Between 2005 and 2010:
    •  The percentage of seniors using 5 or more medications has increased from 30.6% to  35.8%. That’s a 17% increase in just 5 years.
    •  The percentage of seniors using medication combinations with the potential for  major drug‐drug interactions has increased from 8.4% to 15.1%. That’s almost  double and represents 1 out of every 6 senior citizens.
  2. These dangerous drug interactions aren’t trivial. They include excessive bleeding, heart  attack and stroke, renal failure and death, just to name a few.
  3.  There is a better way. Studies have shown that lifestyle change is more effective than  medication at controlling many chronic diseases such as heart disease, high blood pressure,  and diabetes. Lifestyle change has no side effects and no dangerous interactions. More  importantly, you don’t need different lifestyle changes for different diseases. One size fits  all! I have talked about a healthy lifestyle in great detail in past issues of “Health Tips From  the Professor” (https://healthtipsfromtheprofessor.com). In brief, a healthy lifestyle  consists of:
    •  A mostly plant based diet that includes healthy fats, healthy carbohydrates, and  healthy proteins.
    •  Exercise, weight control, and appropriate supplementation.
  4.  So if you or someone you love are taking multiple medications, talk with your doctor about  the lifestyle changes that you are willing to make. Most doctors would be delighted to  reduce the medications you are taking if you are willing to do your part.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Relieve Hip Pain After Sitting or Driving

Posted June 20, 2017 by Dr. Steve Chaney

Relief is Just a Few Movements Away!

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

relieve hip pain after sittingI’m on a long business trip, speaking and teaching in Tennessee and New York, and the drive from Sarasota, FL meant many hours of driving over several days.  One of my stops was to visit with Suzanne and Dr. Steve Chaney at their home in North Carolina.  It was that long drive that became the inspiration for this blog.

After all those hours of driving, my hip was really sore. It was painful to stand up. While talking to Suzanne and Dr. Chaney I was using my elbow to work on the sore area, and when we were discussing the blog for this month it only made sense to share this technique with you.  So, Dr. Chaney took pictures and I sat at his computer to write.  I thought others may want to how to relieve hip pain after sitting or driving for long periods.

What Causes Anterior Hip Pain?

As I’ve mentioned in posts in the past, sitting is the #1 cause of low back pain, and it also causes anterior hip pain (pain localized towards the front of the hip) because the muscles (psoas and iliacus) pass through the hip and insert into the tendons that then insert into the top of the thigh bone.  When hip pain reliefyou try to stand up, the tight muscle tendons will pull on your thigh bone.  The other thing that happens is the point where the muscle merges into the tendon will be very tight and tender to touch. You aren’t having pain at your hip or thigh bone, but at the muscular point where the muscle and tendon merge.

It’s a bit confusing to describe, but you’ll find it if you sit down and put your fingers onto the tip of your pelvis, then just slide your fingers down toward your thigh and out about 2”. The point is right along the crease where your leg meets your trunk.

The muscle you are treating is the Rectus Femoris, where it merges from the tendon into the muscle fibers.  Follow this link, thigh muscle, to see the muscle and it will be a bit easier to visualize.

You need to be pressing deeply into the muscle, like you’re trying to press the bone and the muscle just happens to be in the way.  Move your fingers around a bit and you’ll find it.

Easy Treatment for Anterior Hip Pain After Sitting

relieve hip painHere is an easy treatment for hip pain after sitting you can administer yourself.  First, sit as I am, with your leg out and slightly turned.

Find the tender point with your fingers and then put your elbow into it as shown.

It’s important to have your arm opened so the point of your elbow is on top of the spasm.  It’s a bit tricky, but if you move about a bit you’ll come on to it, and it will hurt.  Keep the pressure so it’s tolerable, not excruciating.

After you have worked on this point for a few minutes you can move to the second part of the treatment.

hip pain treatmentPut the heel of your “same-side” hand onto your thigh as close to the spasm as you can get.  Lift up your fingers so the pressure is only on the heel of your hand.  You can use your opposite hand to help give more pressure.

Press down hard and deeply slide down the muscle, going toward your knee.  You can also kneed it like you would kneed bread dough, really forcing the muscle fibers to relax.

I’m putting in a picture from a previous blog to explain how you can also treat this point of your rectus femoris by using a ball on the floor.

As shown in this picture, lie on the floor with the ball on your hip muscle, and then slightly turn your body toward the floor so the ball rolls toward the front of your body. You may need to move the ball down an inch or so to get to your Rectus Femoris.

When you feel the pain, you’re on the muscle.  Just stay there for a minute or so, and if you want you can move so the ball goes along the muscle fibers all the way to your knee.

pain free living book coverIt may be a challenge to find this point, but it’s well-worth the effort!

In my book, Treat Yourself to Pain Free Living, I teach how to treat all the muscles that cause pain from your head to your feet.

Wishing you well,

Julie Donnelly

julie donnelly

About The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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