be considered a drug side effect until proven otherwise. pHOtO BY BraNdON ScOtt. Another factor that can amplify the harmful effects of multiple prescriptions in older patients is the fact that as our bodies age, drugs affect us differently. “They stay in the system longer,” says Phoenix. “They don’t clear. You can end up stacking doses.” Recommended doses for most drugs are based on younger patients, so an older person with slowed bodily functions may wind up taking more medication than they actually need. Finally, polypharmacy is viewed as a primary reason many patients, particularly the elderly, don’t take their prescriptions as directed. This pill burden, as it is called, may be too much and too complicated to keep up with. Plus, many seniors have a hard time paying for all the medications they are prescribed. According to the Merck Manual of Geriatrics, roughly 40 percent of elderly patients don’t take their prescriptions correctly.
Dr. James Phoenix works with patient Betty Collins to determine what is causing her blood pressure problems.
easily end up with a medicine cabinet full of pill bottles. “One person may end up on a dozen or more medications,” Phoenix says. “We see that a lot.” Unfortunately, Phoenix says he isn’t always aware of every drug his patients take, and this may cause an overlap where more than one drug is prescribed to treat the same condition. Another factor that may increase the number of prescriptions is what Phoenix describes as a cascade effect where patients may be inadvertently treated for side effects of the drugs they are taking. For instance, gastrointestinal problems are a common side effect of many medications, and sometimes patients end up with additional prescriptions to treat these symptoms. Those drugs, in turn, come with their own list of side effects. Phoenix says cholesterol drugs are another common culprit in prescription cascades. “Cholesterol drugs can cause pain, which people may mistake for aches associated with arthritis or another condition,” he says. Most experts agree that any new symptom in an elderly patient on medication should
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Serious Risks The ASCP describes adverse drug reactions as one of the top five greatest threats to the health of seniors. You only need watch a few television commercials to know that every drug has potential adverse side effects, usually a laundry list of possible complications. The more medications that enter the equation, the greater chance the patient will suffer from one or more of these side effects. This matter is further complicated by the fact the every medication can potentially interact with every other medication a patient is taking. “If you’re taking eight or more medications, including over-the-counter medications, there’s a 100 percent chance you’re having a harmful drug interaction,” says Phoenix. The results of adverse drug reactions
When The Smoke Clears
Oklahoma dramatically improves its yearly percentage of adult smokers.
Oklahoma has been notorious for its high smoking rates. this year’s studies, however, show that the habit, statewide, is beginning to shift. the percentage of adults who smoke in Oklahoma has decreased from 26 percent in 2011 to 23.3 percent in 2012, altering Oklahoma’s national adult smoking ranking from 47th in the nation to 39th. this decrease may seem insignificant, but throughout the years, Oklahoma’s poor national ranking has been nearly as consistent as the nasty habit itself. according to State department of Health tobacco Use prevention Manager Jenifer lepard, much effort has brought about this three percent drop. “[We’ve] been working really hard on this issue in the state for about 10 years,” says lepard. Much of the focus in decreasing smoking has been placed on youth outreach and education. throughout Oklahoma, SWat teams (Students Working against tobacco) have formed to educate students of the woes that come from smoking. for this reason, young adults who have never smoked greatly contributed to decreasing the state percentage in 2012. lepard also credits the decrease in smoking to the gradual change of attitude within the state. “people are beginning to understand that it’s about living longer. it’s about living a life that is healthier and more full. and it also costs more money [to smoke],” says lepard. the cost of the amount of work Oklahoma smokers miss each year due to the habit is estimated at $1.73 billion. Moving forward, the state department is anxious to see if next year’s decline will be as substantial as this year’s. – Nathan Porter