Are you taking too many meds?
Canadian seniors taking multiple medications face health risks
July 8, 2015
Most Canadian seniors begin their day by taking at least one medication. As we get older, our medical conditions become more complex and our medicine cabinets get a bit more crowded. What are the risks that come with taking multiple medications? Who faces greater danger – men or women? Dr. Cara Tannenbaum, Scientific Director of CIHR’s Institute of Gender and Health, talks about the potential risks and the possible solutions.
Dr. Cara Tannenbaum
D: This is David Coulombe for CIHR News. The inappropriate use of medication among seniors is troubling. To discuss the safe medication management for older men and women across Canada, we are very pleased to have with us today Dr. Cara Tannenbaum, the scientific director for CIHR's Institute of Gender and Health.
Dr. Tannenbaum, hi
C: Hello David.
D: Doctor Tannenbaum, what do you think about the fact that many elderly people are taking multiple or inappropriate medications?
C: It is very worrying David, you know that with population aging, the number of people over the age of sixty-five in Canada is going to double in the next twenty years. Now what if I told you that nine in ten people wake up each morning and take at least one pill and half of those take five pills or more. If you're over the age of 85, then you have a forty percent chance of taking ten pills or more per day and sometimes, 23. There is a question of safety, there is a question of quality of care, and for me, there's the question of costs. All these need to be addressed.
D: Is it true that one in five elderly persons is admitted to hospitals because of medication?
C: Yes, that's a really good point. So when we have side effects, they can be as serious as the onset of Alzheimer's disease. There was some recent literature showing that if you take a sleeping pill two times per week, you increase your risk of dementia. You could fall and hit your head because of the side effects of a medication. You could fall and break your hip and then be admitted to hospital because of a hip fracture. You may never realize that it was because of the side effect or the interaction of this drug in your blood. But once you're in the hospital, my patients say to me: "Doctor, is there anything I could have done to prevent this hip fracture?" and I have to look at them very sadly and say "well didn't anyone ever tell you that you shouldn't be taking these sleeping pills?"
D: What are the consequences of inappropriate medication for elderly people?
C: I think that it's not only the type of medication that you take. I gave the example of sleeping pills that can cause confusion or memory problems or falls, but the interactions between the multiple medications that you're taking. If you take a diabetes medication for instance and then you are prescribed an antibiotic, the antibiotic can make your diabetes medication stronger. If you are taking a blood thinner and you take an antibiotic, then you could have a higher risk of bleeding. So it's the type of medication that you take, it's the interaction between the medications that you take and the fact that as you get older, your body may metabolize the medications differently so that the same dose or the same drug that you might have been safely taking for seventy years may not be the best choice for you as you go into your seventies and eighties.
D: Can you tell us who is more at risk, men or women?
C: Well, women always win, don't they? So women are more likely to take medications than men as they get older, they are more likely to have side effects and they are more likely to be taking the prescriptions that we consider inappropriate. In the United States, recently they even changed the dose, the recommended dose of sleeping pills that should be given to men and women because the sleeping dose was found to be forty-five percent higher, drug levels of it, in the blood of women than in men. So it's not that women are bad drivers, it's just that they still have too much sleeping pills in their blood.
D: And women always win, you said it! Maybe my last question to end this discussion on a positive note, is there any hope?
C: There is a lot of hope! The hope is going to depend on the people listening to this podcast. There are three things that you can do if you are listening to this podcast and you take medications. First go speak to a doctor; go speak to your pharmacist; ask questions - don't be scared to get off medications. You may be prescribed a medication, ask if you can be de-prescribed a medication. Finally, keep informed about which medication you're taking and why and always ask: can I be doing something safer?
D: Thank you Dr Tannenbaum.
C: You're welcome.
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