Doctors must look at taking elderly patients off long-standing medications

Within months, his 75-year old patient had gone from boasting about running a 5K race to hobbling into his office with a cane. The likely culprit? The blood pressure medications this patient was taking.

This once spry patient had fallen from a chair, which resulted in a bad knee sprain and the need for a cane. The best way to keep his patient healthy was to de-prescribe some of those medications, writes Ravi Parikh, M.D., a resident physician at Boston’s Brigham and Women’s Hospital in the Washington Post.

Parikh’s elderly patient is like many across the country. According to a 2006 study, more than 50 percent of older Americans are taking as many as five or more medications. In fact, between 17 and 19 percent of older men and women take ten or more medications each week.

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Parikh empathizes with other physicians who prescribe medications to treat a particular condition. His patient, for example, once needed to take three medications to help manage his blood pressure. The question doctors need to ask is whether patients should be on these medications throughout their lives.

“This line of thinking creates a problem, even when a prescription is warranted. Many conditions, including heartburn and high cholesterol, don’t last forever; they are a result of temporary stress or a reversible behavior,” he writes. “But as patients bounce from doctor to doctor, we physicians hesitate to step on another doctor’s toes by discontinuing a medication.”

Parikh’s patient has since volunteered to stop taking one blood pressure medication, in addition to medications that once lowered his cholesterol and prevented headaches. So far, his patient has experienced no falls and his blood pressure is in check.

Along with taking many medications, doctors need to worry about elderly patients taking their prescriptions properly. A recent study found that fewer than one in every eight elderly patients takes medicines appropriately, a practice linked to an increased risk of hospitalization or death.

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