Are 28 Medications Too Many?
It’s called polypharmacy and it’s not just happening to the elderly. I'm proof.
Posted Apr 04, 2021 | Reviewed by Jessica Schrader
I’m the one who is taking 28 different medications.
I carry a typed medication list around with me. The list runs on both sides of the page. I never really counted the number of medications and I was horrified. On some level, I didn't want to know the exact number. One study defines polypharmacy as regular use of at least five medications, being common in older adults and younger at-risk populations and increasing the risk of adverse medical outcomes.
The same study states polypharmacy has negative consequences for patients and the health care system. For example, patients taking more than four medications have an increased risk of injurious falls, and the risk of falls increases significantly with each additional medication, regardless of medication type.
Who fell and fractured her wrist recently?
Some medications I take twice a day, some in the morning and some at night—or hour of sleep (HS). A few I take PRN, which means as needed and a couple I take once a month or once every two weeks. These are self auto-injectors for my migraines and asthma. There is even one I get once a year—an infusion for my osteoporosis. But there are 28 in total and that doesn’t count the eight supplements, which includes vitamins, a probiotic, and other assorted weird-sounding medications, mostly to help my migraines.
I hear often that your PCP is supposed to be the “quarterback” of your medical team. I had a follow-up visit with my PCP earlier this week. I waited an hour for a 10-minute visit during which I brought her up to speed. This is typical. Why do I put up with this? Because if I need to see her the same day, she will usually squeeze me in. So it’s a trade-off.
Do I think she has time to sit in her office and call all my other prescribing doctors—my headache specialist, my neurologist, my endocrinologist, my pulmonologist, my rheumatologist, my cardiologist, my gastroenterologist, and my psychiatrist—and have an in-depth conversation with them about the one or more medications each of them are prescribing me?
Somehow I doubt it.
I would love to get off some of these. They fall into categories. Migraine. Asthma. Post-stroke. Depression. Cardiac. Gastrointestinal. Autoimmune. Osteoporosis. When I look at what each one does and how it helps me function, it seems necessary to maintain my shaky sense of what passes for health. Like some people live paycheck-to-paycheck praying that no sudden and expensive disaster befalls them, I pray that no sudden costly medical condition befalls me that would require yet another prescription.
We won’t even talk about the time it takes to pour them. I was doing it every morning, now that I’m on medical leave for my wrist, I sort about four days at a time. It's tedious. And if I make an error, how am I going to realize I made a mistake? I can gulp down about 10 pills at a time.
You guessed correctly that the pharmacist knows me by name. I feel as though I’m putting their kids through college. For the last couple of years, I’ve received a holiday card from them, and I give the staff there some holiday cookies for putting up with filling over 20 scripts everyone month.
My physical therapist, with whom I’ve been working since 2013 has this fantasy that I’m going to detox from all my meds cold turkey. At least that what she wants me to do. As tempting as the offer is, I politely decline every time she brings up the issue.
Yesterday I stopped one medication. My headache specialist is no longer in-network with my insurance and she was prescribing me something to help me sleep. It wasn’t really working and I ran out of refills, so I will just drop it.
Twenty-seven to go.
Thanks for reading.