Dangers to Seniors
While there are some cases where polypharmacy is necessary and beneficial, generally speaking, the more medications a resident takes, the greater the health risks. Some of the top health consequences of polypharmacy are:
Poor Adherence
Medications are only effective when they are taken as directed. A greater number of prescriptions complicates administration, and residents may forget to take them or take them at the wrong time. When that occurs, their condition may worsen.
Adverse Drug Events
While a single drug carries with it the risk of adverse outcomes, the combination of medications can prove even more dangerous. Drugs can interact in harmful ways, such as cancelling out the intended effect of a medication, leading to treatment failure or the creation of new risks. Seniors are at a particular risk of adverse drug reactions because of age-related changes in pharmacokinetics (e.g., absorption, distribution, metabolism, and excretion) and pharmacodynamics (the physiologic effects of the drug).
Hospitalizations
Adverse drug events can lead to emergency hospitalizations along with unintentional overdoses.
Falls
Studies have shown there is an increased risk of falls as the number of medications increases as well as with specific classes of drugs such as antipsychotics. Falls can cause serious injuries that can lead to functional impairment, a lower quality of life, and increased risk of mortality.
Decreased Function and Cognition
Polypharmacy has been found to reduce physical function in older adults, which can decrease a resident’s ability to perform daily living tasks. It has also been linked to lowered cognitive function, especially with specific drug types like psychotropics.
Mortality
Polypharmacy is associated with elevated mortality risk in elderly patients.
Medication Errors
Prescribing or monitoring rates increase with the number of medications prescribed.
In addition to the negative health consequences of polypharmacy, it can also impact a senior’s quality of life. One such effect is “pill burden,” which is the need to take medications at various times throughout the day and night. Side effects from multiple medications and/or drug interactions can also create anxiety and depression. Moreover, the cost of multiple medications can be burdensome, particularly for older adults on fixed incomes.
Patients taking five to nine medications have a 50% chance of an adverse drug interaction.*
The risk of injurious falls increases in a nearly linear fashion for each additional drug.*
*Morin L, Calderon Larrañaga A, Welmer AK, Rizzuto D, Wastesson JW, Johnell K. Polypharmacy and injurious falls in older adults: a nationwide nested case-control study. Clin Epidemiol. 2019;11:483-493. Published 2019 Jun 24. doi:10.2147/CLEP.S201614