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How do we Handle the Patient Polypharmacy Problems in the United States?

Polypharmacy is the use of multiple medications by a patient. There is no clear definition of polypharmacy. Often it is the overuse of medications and is more common in the elderly.

The problems which come from the use of multiple medications include increased incidence of adverse drug reactions, increased drug interactions and medication side effects which affect qualities of life such as cognition and mobility. Due to the lack of information technology in the U.S. there is more frequently than not a lack of communication between individual physicians’ offices. This is true not only of physicians in separate and unrelated practices but also among large patient group physicians. It is not at all uncommon to register and fill out all the requisite paperwork at a large medical complex only to go down the hall and see another one of their physicians and have to fill out all the same paperwork again. There is simply no connectivity.

Because of these very few problems listed above patients may end up on multiple medications and be overdosed with another medication, with the same medication prescribed by multiple doctors.

Patients are often at a complete loss. The reasons for this include having multiple names for the same medication including brand and multiple generic names. In addition to this there are many different formulations for the same medication including capsules and tablets. There are also many different shapes, sizes and colors for the very same medication. There is every possible reason or combinations of reasons thereof that patients end up on too many medications with many unintended side effects.

These problems are not the problems immediately of the medical profession. A physician or their staff cannot be responsible for identifying a sack full of unlabeled medications that come into the office with the patient saying, “These are the medications I am on”. This is simply too onerous a problem to be handled in a physician’s office. If the patient ends up overdosed on something because the patient did not know the medications they were on, it should not end up being the responsibility of that office or that physician. It is ultimately the responsibility of the patient who did not see fit to participate in their own healthcare on this particular occasion.

The final take away message from this is to make sure you know what medications you are on. Know about the medications and their side effects. Keep a list of your medications on you at all times. Keep also a description of the medication and the intended use for which it was prescribed.

If you have allergies or know of drug interactions you may have, wear a medic-alert bracelet letting your healthcare workers know about your problems in the event you are unable to let them know for any reason.

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