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Is Less Really More When it comes to Prescriptions?

The danger taking too many medications has been hotly debated as of late. At CareerStaff Rx the issue has particular importance because we recognize our employees in the pharmacies are the last check before a prescription falls into the hands of a patient. We believe it is valuable to stay current on this kind of information in order to continue providing the best quality of service. It seems there is a prescription to cure almost any ailment, but does that mean we should be taking every one that comes our way? Michael Wincor, a professor at the University of Southern California, says it is common for patients to receive several prescriptions from a multitude of different specialists who each focus on a different problem with the patient. This kind of medicine becomes dangerous when the specialists neglect to communicate with the other physicians the patient is seeing. Often times the adverse effects of mixing medications lead patients to believe they have a new problem or worsening condition. In reality, the cause of these effects may be bad interactions between the drugs taken by a patient. “The drug-drug interactions can be worse than the disease,” says John Morley, the director of geriatric medicine at the St. Louis VA Medical Center. The problem is often exacerbated because, “doctors seem to suspend common sense when devising a treatment plan” he says. One patient may be prescribed Aricept for Alzheimer’s which often causes urinary incontinence and then be given Ditropan to treat side effect. The problem is Ditropan itself often causes delirium, confusion and memory loss. Doctors should only be prescribing drugs with benefits to the patient that outweigh the risks for that individual, that is why Americans pay to see them and consult their medical expertise.  

But are doctors the only ones to blame for the problems of overmedication? Bruce Psaty, a professor at the University of Washington, says another problem is, “companies often lack an interest in addressing safety questions after a drug is approved” by the FDA for market use. Danger also arises from the fact that clinical studies may not fully demonstrate the risks associated with a product for long-term use or for people with multiple health problems and multiple medications. Pharmaceutical companies are also in the business for profit, which is something consumers need to remember. Commercials advertise strong anti-depressants to treat mild cases of “feeling alone” and this helps drive demand. The trend of treating mild ailments with strong medications is prevalent in both young and old patients. Prescription drug usage has increased 39% in the last decade according to the Kaiser Family Foundation. Today 61% of adults use at least one drug to treat a chronic health problem which is a 15% increase since 2001. Mixing medicines has become particularly dangerous for seniors, 25% of whom take at least 5 different medications daily. Seniors are also classified as the most at risk group for serious negative consequences from side effects. Dr. Russ Altman, a professor at Stanford University, states, “Many side effects from drug interactions (not all) are exacerbations of known side effects of the single drugs that are made worse by the two drugs together.” Seniors are particularly at risk because of the sensitivity to these interactions caused by their old age.

However medicine, even the strongest prescription, is not always bad. So who exactly is responsible for its safe practice? Clearly doctors and pharmaceutical companies should be accountable for using safe methods of both testing and prescribing drugs. Additionally, as a trusted, reliable source of information, pharmacists should ensure they double check the prescription orders of their customers and discuss points of concern. However, patients also need to ask questions themselves and act as their own advocate. Questions like, “What are the side effects of this medication? What will these effects do to someone with my medical history? And what are the benefits of this drug for me?” are great conversations to have with their specialists, physicians and pharmacists. A pharmacist may, in fact, be the best person to talk to considering they could be the only one with every prescription or piece of information in front of them. Therefore, pharmacies should be encouraging their pharmacists to hold conversations with customers. The nature of medication guarantees that drugs will, by definition, have some toxic, negative side effects. It is important to keep this in mind from the perspective of a pharmacist as well as a patient the next time a prescription is being filled.  

References:

http://www.cnn.com/2011/HEALTH/05/31/med.nation.too.many.meds/index.html

http://health.usnews.com/health-news/managing-your-healthcare/diabetes/articles/2010/10/07/overmedication-are-americans-taking-too-many-drugs?page=2