EDITORIAL: Reduce harmful effects use of multiple medicines has on elderly people

TOKYO (The Japan News/ANN) - By taking too many kinds of medicine, more than a few elderly people conversely end up harming their health. It is crucial to establish a system that prevents problems caused by taking multiple medications.

 The Health, Labor and Welfare Ministry is drawing up the first guidelines on drug administration and prescription to elderly people. These guidelines will soon be provided to medical institutions and other facilities. Intended for use by doctors and pharmacists, these guidelines detail the medicines commonly used for elderly people, and their main side effects, and also call for more prudence when issuing prescriptions and creativity in finding ways to reduce medication use.

 Side effects are more likely to occur in elderly people as their ability to metabolize medicines declines. Elderly people tend to take more kinds of medication, while suffering several ailments. The interaction of these drugs can often harm their health. In some cases, a patient falls into a vicious cycle in which symptoms caused by taking a certain medicine are treated with another drug.

 It is thought that when a person is taking six or more kinds of medicine, the number of instances in which they feel unwell spikes. In many cases, typical symptoms of taking many kinds of drugs, such as unsteadiness, memory impairment, loss of appetite and depression, are overlooked as physical ailments caused by old age.

 Forty percent of Japanese people aged 75 or older get five or more kinds of medicine each month from a single pharmacy. Twenty-five percent get seven or more kinds. It seems that personnel on the medical front line do not properly recognize the harmful effects of administering multiple kinds of drugs.

Team effort required

 When a patient’s condition changes, suspect that medicines could be the cause — it is vital that such an approach becomes entrenched.

 The guidelines emphasize the necessity of doctors, pharmacists and other medical professionals working together to grasp the entire picture of medicines prescribed to each individual patient.

 In a striking number of cases, patients use several medical facilities and pharmacies to get the same medicine or drugs that should not be taken together. A patient’s family doctor should have a grasp of all their prescriptions, including ones that they get from other medical facilities, and their pharmacist should consolidate information about the medicines being taken. This must be a first step toward preventing patients from harming their health.

 The guidelines also recommend doctors and others should determine the effectiveness and necessity of a patient’s prescription medication and consider safer alternative drugs or treatments other than medicine. Patients need to be carefully monitored and their use of medication should be reduced.

 The problem is securing enough family doctors and pharmacists with the skills to do this. Nursing care staff and other workers involved in giving medicines to patients also should become more aware of problems created by using multiple drugs and cooperate with medical personnel on this issue.

 The overlap of medicines with the same effects, which can arise when many kinds of drugs are prescribed, and medication that goes unused push up medical costs. Some estimates put the cost of leftover medicines at tens of billions of yen per year. Measures to prevent this also are urgently needed from the perspective of curbing swelling medical costs.

 The understanding of a patient and their family will be essential for promoting the proper use of medicines. Taking medication comes with a risk. The government must do more to educate people about side effects particular to elderly people.

 Patients also should try to prevent harming their health, such as by using a “medication record book” to keep track of the medication they take.

(From The Yomiuri Shimbun, May 17, 2018)

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