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America's Polypharmacy Predicament

By DrugTopics, Drew Boxler on 4/05/2019

The current healthcare culture is being likened to a dangerous concoction of excessive prescriptions in a recent report published by the Lown Institute. 

According to “Medication Overload: America’s Other Drug Problem," 750 adults over the age of 65 are hospitalized every day due to the side effects from one or multiple medications. Over the course of the past decade, these adverse drug events (ADE) resulted in more than 35 million requests for treatment and 2 million hospital admissions. 

ADEs, as described in the report, are most often a result of polypharmacy—the tendency toward prescribing an excessive amount of medications to one patient in order to mitigate the negative side effects of other prescriptions. With each medication added, whether it is the first medication to treat a disease or subsequent medications to alleviate side effects, the risk of an ADE increases between 7% and 10% with each additional prescription. 

Today, Lown says, more than four in 10 adults are taking more than five prescription medications per day. Twenty percent of those adults are taking more than 10 drugs per day. When considering supplements and OTC products, nearly 67% of all older Americans are taking medications — a 300% increase when compared with previous decades. 

The Lown Institute cites three particular aspects of the current practices in medical treatment that have led to the culture of polypharmacy: an emphasis on prescriptions as one of the easiest and more effective ways to help patients and reduce pain, information and knowledge gaps between physicians and patients, and the fragmentation of care among specialists and primary care physicians. 

Recognizing the growing threat to patients, the Lown Institute — a nonprofit organization operating out of Brookline, MA—has made it their mission to address instances of poor healthcare value and emphasize the threat to patients, while simultaneously working with healthcare practitioners to develop better healthcare practices. 

To develop this report, the Lown Institute worked with doctors, nurses, advocates, researchers, and pharmacists beginning in July 2018. The group plans to release a more comprehensive report—the National Action Plan for Addressing Medication Overload—by early 2020.