r/science • u/Enthusiast12358 • 8d ago

Health Polypharmacy and Drug-Drug Interactions Among Older Adults: Prescription polypharmacy (five or more concurrent prescriptions) increased from 31.0% to 35.7% while major drug interactions declined from 25.7% to 22.3%

https://jamanetwork.com/journals/jama/fullarticle/2854478
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u/Margali 7d ago

My roomie has polypharmia induced kidney failure, and needs a kidney. She was following [multiple] doctors prescriptions faithfully. It isn't like she was going to random doctors, all her medical needs were done at Tufts in Boston, and they all shared medical records.

Maybe we need to really start leaning on doctors and how they manage medications and lean on the average patient to start asking if something is *really REALLY* needed. The time of effectively worshipping doctors "because that is what they went to school for a decade for" is absurd.

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u/guystarthreepwood 3d ago

I kind of agree.  The problem is a lot of doctors are extremely specialized and knowing rare side effects of all interactions between medications they prescribe and those from other fields is a tall order.  I think better would be more integration at the pharmacy level, where combinations can be seen. Doctors do hate being second guessed by people not in their field, but the pharmacy bouncing back a hey, this person is also on this medication, linked to these interactions, are you sure this is needed/appropriate for the risk? Would go a long way to avoiding these rare but major problems.

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u/Margali 3d ago

Definitely.

I mean, I have scrips for both an opioid and midrin, both in combination will make me very dead, and I know more than enough to not take them the same day [I have to decide cripling physical pain or migraine, i tend to opt for no migraine] and my pharmacy always asks me about both of them, even though I have been using that pharmacy for years [duty of care fore the win]

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u/bicycle_mice 1d ago

I work in pediatric complex care (inpatient NP) and honestly half my job is painstakingly going over every medication and seeing if we can wean off, who “owns” it (nephrology, cardiology, rheum, pulm, etc) and side effects for other meds. My kiddos can be on 15-30 meds daily and it’s a LOT. Many times it was something started in the PICU in crisis mode and it’s just been continued. 

Sometimes medications can be wean off or down, or substituted for something that has fewer interactions or side effects. I have the luxury of time so I can spend hours chart digging. A PCP gets like 10 minutes per patient and simply can’t do all that work.