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shootingstar
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For me, the vaccines has been the most medication so far.

I did take a sleeping pill which I chopped up in 1/2 ...for a few wks., 7 yrs. ago when my sleep was disrupted when recovering from concussion. Then I stopped. I found out it was actually a light anti-depression pill. While my sleep is a bit better I have chosen not to taken  any other sleeping medication...the physician did say the body can get addicted.

 

Prescription overload is a serious and growing health issue for seniors

DENE MOORE
SPECIAL TO THE GLOBE AND MAIL
PUBLISHED 2 HOURS AGO

 

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It was while working in acute care at McGill University Health Centre that the epidemic of overmedication of older Canadians became clear to physician Emily McDonald.

“We were seeing older people coming in with fall fractures, hip fractures, delirium, confusion,” Dr. McDonald says. “And a lot of it could be pretty easily traced back to medications or combinations of medications that they were taking.”

Going over the list of prescription medications they were taking, it was clear many were not appropriate, she says. The diagnosis was prescription overload.

“It’s a massive problem,” says Dr. McDonald, an associate professor of medicine and director of the clinical practice assessment unit in general internal medicine at McGill University Health Centre.

“More than half of people over the age of 65 are taking more than five medications and when you look in long-term care – the most vulnerable people – they’re taking at least 10 medications a day.”

About 10 per cent of their hospitalized patients take 20 medications, says Dr. McDonald, who is also a scientist at the Centre for Outcomes Research and Evaluation.

“Some people are taking 30 pills a day. They don’t even have an appetite for their meal after they’ve taken their morning pills,” she says. “Their brain is all foggy and cognitively, it’s affecting them.”

Raising awareness about overmedication

In 2015, health care leaders, clinicians, government decision-makers, academics and patient advocates formed the Canadian Deprescribing Network. The network works closely with the Canadian Institute for Health Information, a not-for-profit federal corporation, to raise awareness and work toward eliminating overprescribing and ensuring access to safer drug and non-drug therapies.

“Sadly, while we set out to try and target a 50-per-cent reduction, changing the way we use medications is really difficult,” says Justin Turner, co-director of the network.

For example, Dr. Turner says sleeping pills are one of the most commonly prescribed medicines more likely to cause harm than provide a benefit. One in 13 patients benefits from sleeping pills, while one in six is likely to experience harm, he says. That includes an increased likelihood of falls or cognitive impairment.

Research shows that driving the day after you take a sleeping pill can result in the same chance of a car crash as driving drunk, notes Dr. Turner, who is also an assistant professor in the pharmacy faculty of the University of Montreal.

He says that, through public and health care provider awareness campaigns, sleeping pill prescriptions are starting to decrease a bit across the country.

Dr. Turner points to Denmark, which has taken a more stringent approach.

“If you’re over 70, where the risks of harms get considerably greater, you can have your driver’s license or you can have your sleeping pills. You can’t have both,” Dr. Turner says of the Scandinavian country’s policy. “That was the single most effective policy in the world for reducing sedative use, with a 20 per cent reduction.”

Cognitive therapy is often effective for sleep disorders but in this country, sleeping pills are paid for from one budget and cognitive behavioural therapy or psychological therapy are paid for from another, he adds.

“It’s the same with opioids,” Dr. Turner says. “It’s easy to prescribe an opioid for back pain, for example, because it’s covered, whereas physiotherapy and treatment for that may not be covered. So what are you going to do for a patient who can’t afford physiotherapy? Well, we’ll give them a drug because it’s covered.”

A similar problem leads to high use of antipsychotic drugs in long-term care settings, he says.

Most provinces have signed on to an initiative by the Canadian Foundation for Healthcare Improvement to reduce the use of these medications in long-term care. Dr. Turner says there are success stories across the country and the focus now is to work with policymakers to scale those successes nationally.

Industry statistics show Canada spends $400-million a year on drugs classified as inappropriate and $1.4-billion a year fixing the side effects of those drugs. In some cases, medications snowball over time, getting renewed even when they stop being appropriate.

Most clinical trials also exclude seniors, so their effect on changing senior physiology is unknown. Clinical trials also don’t study the interactions of drugs with other drugs. Add to that Canada’s siloed health care system, with multiple health care providers, and there is no definitive system in place to review a patient’s prescription use.

A 2017 study by the Institute for Research on Public Policy (IRPP) found that on average, two-thirds of Canadian seniors take five or more prescription drugs over the course of a year and a quarter of them take 10 or more.

It was estimated as much as half of those medications were taken incorrectly or overprescribed, increasing the likelihood of adverse drug reactions or interactions, the report said.

How holistic health care can help

A more integrated team health approach has proven effective, with physicians, dieticians, physiotherapists, pharmacists and a whole team collaborating on treatment, says Colin Busby, research director with the IRPP

“It’s this issue of design,” he says. “You need a centralized person who gets information whenever a patient is getting prescribed something. It pops up on somebody’s screen somewhere and they know that this person’s being prescribed a medication, and they can evaluate it.”

Manually, such a review takes 15 to 20 minutes, which means most general practitioners don’t have the time, Dr. McDonald adds.

She and her colleague at the Research Institute at McGill University Health Centre, physician Todd Lee, came up with an electronic tool called MedSafer that aims to fill the void. MedSafer automatically cross-references the medical history, medications and guidelines for safe prescribing for older adults to flag intermediate- or high-risk drugs and potential adverse interactions.

Too often, drugs are being prescribed to treat the side effects of other drugs, she says. Or those side effects are simply attributed to aging.

“We just think, well, dad’s memory is bad because he’s getting older,” she says. “We don’t realize that if you stopped his bladder pill or his sleeping pill, his memory might actually get a little bit better.”

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Excessive medication killed my mother.  All medications rely on the kidney's and other body functions to remove the excess lest it poison you.  She suffered and extreme bout of intestinal trouble, became dehydrated and her kidney's didn't do their job.  Coma followed by death.  Make sure you know what you're taking and how it behaves in your body.

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9 minutes ago, Gump said:

Most had side effects worse than what they were treating.

It is insane.  Realistically, though, it's more: "Most had potential side effects worse than the ACTUAL condition they were treating."

Folks with something chronic are often put in the difficult space of risking worse (however small the risk) to treat/cure something they face all the time.

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Zero.......the lady that injected me yesterday said I could take a couple Tylenol but I choose not to.  During a full physical,  doc said my cholesterol was a bit high so if I chose, she would prescrib meds. No thanks, did a search and realized those meds would increase the diabetes.  I am type 2 and chose to exercise and eat well vs meds. Seems to be working. 

Now my mother,  21 pills per day  and yes, it's affecting her brain. If she reads the pamphlet included with the meds, she'll get every side affect listed. 🥱

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for every $1,000 spent on prescription drug ads, 24 new patients were added for the pharma industry. Additionally, a 2003 research report found that rates for prescription drugs with ads were almost seven times greater than for those without ads.

 

None for me, thanks.  I took some Naproxin in October to get my inflamed ITB through a bike ride.  That's about it.

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I was on seven prescriptions for my blind eye, now that my vision has returned it’s cut back to two kinds of prescription eye drops. I take Crestor for cholesterol and Brilinta an anticoagulant and an 81 mg aspirin.

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1 hour ago, ChrisL said:

A lot… 

Oops,  accidentally hit like.  Not liking the fact you have to take meds. Just hit it on accident. 🤪

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Amlodipine (Norvasc)     10mg

Fexofenadine (Allegra)  180mg

Flovent HFA                   44mcg x2

Lisinopril                        40mg

Omepazole (Prilosec)    20mg

Crestor                          40mg

Aspirin                         81mg

Indomethacin (Indocin)  50mg    as needed for gout

NITROSTAT Subl Tab    0.4mg    In case of heart issue

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5 minutes ago, Mr Beanz said:

Oops,  accidentally hit like.  Not liking the fact you have to take meds. Just hit it on accident. 🤪

Well, depends. Like LJ, probably at least one them....if not taken, would be..death.

If I remember, I take a combined  calcium-iron. 

I think my mother takes 6 or something like that. She will  88 soon.

 

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19 minutes ago, 12string said:

for every $1,000 spent on prescription drug ads, 24 new patients were added for the pharma industry. Additionally, a 2003 research report found that rates for prescription drugs with ads were almost seven times greater than for those without ads.

 

None for me, thanks.  I took some Naproxin in October to get my inflamed ITB through a bike ride.  That's about it.

For sure, that advertising budget... :(   TV ads  --so unnecessary for lay folks.

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A lot for me too. They’ve kept me alive, but not my favorite solution. I turned down the blood thinner which the doctor said had a 40% chance of death or serious damage vs the unquantified risk of not taking it. Tough decisions. 

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28 minutes ago, 12string said:

for every $1,000 spent on prescription drug ads, 24 new patients were added for the pharma industry. Additionally, a 2003 research report found that rates for prescription drugs with ads were almost seven times greater than for those without ads.

 

None for me, thanks.  I took some Naproxin in October to get my inflamed ITB through a bike ride.  That's about it.

American Greed had a fun (sick) episode of how the Insys company pushed their fentanyl derivative to doctors and got it prescribed in massive quantities.  All around getting the doctors to write the prescriptions.

S14 E190 | 02/08/21: The Fall of an Opioid Mogul

As the opioid epidemic destroys the lives of millions of Americans, billionaire drug mogul John Kapoor looks to cash in with his company Insys, which has its own brand of fentanyl.

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Sorry, just to be clear, I'm not saying everyone on meds has fallen prey to the advertising.  I absolutely understand the need for medicine, it's amazing stuff.  I thank God I've been fortunate so far to not need any.  I just wanted to point out a related issue.

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29 minutes ago, Mr Beanz said:

Oops,  accidentally hit like.  Not liking the fact you have to take meds. Just hit it on accident. 🤪

All good. I’m surprised, (happy for you surprised) that you are type 2 but not on any meds.  Most of my ailments are diabetes related or made worse by it.   But everyone’s experience with the disease is different. 

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33 minutes ago, Square Wheels said:

Up until last week, none.  Things change.

Hope can slide through, for next decade or more, if medication is required, by getting by on only 1-2 if something develops.

None of my 4 siblings take any. They range from 53-61 yrs. old.  I think my mother started on her lst medication for blood pressure in her 60's.

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I take Metformin, Glimepiride, Piaglitizone, and Novolog insulin for type-II diabetes, Losartan for blood pressure, and Latanoprost eye drops to ward-off glaucoma.

I also take non-prescription generic Zyrtec for "large particle allergies." in the Spring and the Fall.

 

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40 minutes ago, shootingstar said:

Hope can slide through, for next decade or more, if medication is required, by getting by on only 1-2 if something develops.

None of my 4 siblings take any. They range from 53-61 yrs. old.  I think my mother started on her lst medication for blood pressure in her 60's.

I wasn’t on any medications until after my first heart attack when I was 70 and taking care of my honey. Oops, I was taking Latanoprost eye drops for a few years.

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8 hours ago, Gump said:

None for me. We watched an hour of tv the other night and kept count of the drug commercials, 12 in the span of an hour. Most had side effects worse than what they were treating.

I never know what those drugs are trying to treat

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3 hours ago, Longjohn said:

I wasn’t on any medications until after my first heart attack when I was 70 and taking care of my honey. Oops, I was taking Latanoprost eye drops for a few years.

Since you had been cycling, kayaking, etc., did the heart attack surprise you?  What  did you learn from your doctor?  You see dearie, had a heart problem discovered in his early '70's or so. So he had to have a heart stent, after various tests and heart imaging, etc. He was on blood thinner for almost a yr.   For all the cycling he did, nearly daily too since we didn't have a car.

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5 minutes ago, Airehead said:

I never know what those drugs are trying to treat

You don’t need to know, you are supposed to ask your doctor if colonblast is right for you.

I just changed insurance Jan, 1st. I just picked up my prescription of Brilinta. It had a $435.00 co-pay. That should be the last time I have to refill it.

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I take Losartan for BP control.  Since I've long outlived members of my family that succumbed to high blood pressure I can't complain about taking a pill.  The pill however is not a magic cure.  Diet, exercise and good thoughts are part of the equation as well.

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10 minutes ago, shootingstar said:

Since you had been cycling, kayaking, etc., did the heart attack surprise you? 

Not really, I had been taking care of Esther 24-7 so I wasn’t cycling or kayaking or going to the gym. I was getting more lax on what I ate too because I would cook whatever my wife wanted to eat. I started out making her food and my food but that got old with everything else I was doing. I knew stress wasn’t good for my health but when you are taking care of your spouse of 45 years and you already know this isn’t going to end well it is hard to not be stressed. I have three stents now. The rules on Brilinta is you have to take it for one year after you get a stent. I had gone six months when I had the second heart attack so that added a year onto the time I have to take the anticoagulant. I’ll be done in March.

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6 hours ago, ChrisL said:

All good. I’m surprised, (happy for you surprised) that you are type 2 but not on any meds.  Most of my ailments are diabetes related or made worse by it.   But everyone’s experience with the disease is different. 

My doctor said she'd monitor me and if I proved that I could control it without meds, she'd be cool with it. I  went down from 7.5 to 6.1 with exercise and changing my diet. 

I  love food but I eat nachos like once a month and ice cream once a week now.

Which these were part of my diet like 4 or 5 days a week before finding out. 🤣 

I saw diabetes eat my dad piece by piece. Amputations, dialysis.  I told myself I wouldn't let that happen to me.  He wouldn't change much to make things better for himself. 

I try but maybe I'm just lucky as I've been told by several relatives who are suffering big time. 🤔

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12 hours ago, Mr Beanz said:

Now my mother,  21 pills per day  and yes, it's affecting her brain.

Last fall, I was visiting my dad.  My sister was there managing his pills. OMG the dining room table looked like a drug a store.  I'll guess he takes 15 to 20 pills per day.   And then when he can't walk about 100 feet without getting winded, like he just ran a marathon, there is concern about his health?   Really...  he's 91 it's a miracle, he can take that many meds and stay wake, let alone move.  

I'm just the older big brother who many years ago, moved about 2 hours away.  So I'm not asked about what should be done or not... so  he gets the pills.  

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31 minutes ago, Bikeguy said:

Last fall, I was visiting my dad.  My sister was there managing his pills. OMG the dining room table looked like a drug a store.  I'll guess he takes 15 to 20 pills per day.   And then when he can't walk about 100 feet without getting winded, like he just ran a marathon, there is concern about his health?   Really...  he's 91 it's a miracle, he can take that many meds and stay wake, let alone move.  

I'm just the older big brother who many years ago, moved about 2 hours away.  So I'm not asked about what should be done or not... so  he gets the pills.  

Same with my mom.  Can't walk to the mailbox without getting winded. I had her walking the mall 3 times around.  But the others think it's better she take pills. Even her doctor said whoever tries to get her to walk is the smart one. 

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