July 17th, 2019
Over the past twenty years, the number of older adults taking five medication has tripled, the Lown Institute wrote in their recent report, Medication Overload: America’s Other Drug Problem. What’s behind this drastic increase in multiple medication use?
One of the authors of the report, Judith Garber, was featured recently on the Age of Being 2020 radio program, hosted by gerontologist and author Barbara Matthews. On July 15, they talked about some of the important drivers of medication overload, as well as the solutions the Lown Institute is considering for their upcoming action plan.
One likely reason why medication use is increasing is because of policy changes making it easier for drug companies to reach patients directly. “Marketing of drugs by pharmaceutical companies does play a role here,” said Garber. “In 1997, the FDA opened the floodgates for direct-to-consumer broadcast advertising. Since then, there’s been an explosion of direct-to-consumer drug advertising.”
However, advertising is not the only driver of medication overload. Clinicians often have little time with patients (only 6-8 minutes on average), which doesn’t leave room to discuss medications. There’s also little guidance for clinicians who want to deprescribe, or discontinue medications.
Fragmentation of care also has a large impact on multiple medication use. Our health care system is set up to treat every condition separately, but it’s not very often that a doctor is going to look at all of your conditions and medications at once, and evaluate how they work all together. And clunky electronic medical records make it difficult to know all of the medications patients are taking.
“Big box stores do a better job of keeping track of inventory than the American health care system does in tracking patients’ medications,” said Garber.
A few of the solutions discussed included integrating pharmacists into care teams, better coordinating of care, doing medication reviews during care transitions, and encouraging patients to ask for “prescription checkups” — a medication review based on shared decision making.
There are also questions patients can ask their doctor before they receive a new medication:
Listen to Judith Garber on the Age of Being 2020 program here !