Drug interactions are a growing threat to older adults


By Bill Motchan, Special to the Jewish Light

Memory loss. Difficulty breathing. Impaired vision. Rapid heart rate. Nausea.

Those are just a few medical issues faced by older adults — after taking medication. These side effects are all too common if two or more medications interact with each other and, in the process, do more harm than good.

About one-third of older adults who take prescription drugs experience problems caused by the interaction of medications. And most older adults take multiple prescription medications. Nearly 19 million adults ages 65 and older take five or more medications a day. Even over the counter medications have the potential to interact with prescription drugs and create new medical conditions.

This problem is growing as pharmaceutical companies develop new treatments and doctors prescribe them, said Hedva Barenholtz Levy, a geriatrics specialist who consults with older adults and their caregivers.

“It’s very common,” said Levy, 57. “The interactions can lead to a minor side effect or something more serious that can lead to hospitalization.”

Levy, a member of Kol Rinah, is the author of a soon to be published book titled “Maybe It’s Your Medications.” She aims to educate older adults, their family members and caregivers about the potential for problems associated with medications and their interactions.

“My goal is to help people engage with their health care providers,” Levy said. “I want to empower older adults to take a stand for themselves, know what the risks are and know what questions to ask.”

For example, when a prescription is filled, the pharmacist routinely asks, “Do you have any questions about this medication?” Most people don’t ask anything, but it’s a good opportunity to do just that, Levy said. The first key question should be: “Could this medication interact with anything else I’m taking?”

The pharmacist can provide guidance on the medication’s side effects. He or she is trained to know how prescription drugs interact and can be an excellent resource to warn against potential problems. The prescribing doctor also should know about drug interactions, but when multiple physicians prescribe drugs for the same patient, the likelihood of interactions increases.

“Physicians prescribe with the best intent,” Levy said. “They know the medicines they work with very well. They know safe parameters for prescribing. Pharmacists are trained to guard against interactions. But problems happen sometimes.

“Another thing I see a lot is when errors occur in the home. Patients might not be taking the medication correctly. They could be combining the prescription medication with a nonprescription medication like a sleep aid, a pain medication or a dietary supplement that could lead to adverse events.”

Adherence, the term for taking medications correctly, is especially important. Studies have shown older adults sometimes forget to take their meds or don’t follow instructions for taking them correctly.

“If people are not taking their medications, that’s something that needs to be brought to the attention of a caregiver or medical professional,” Levy said. “A home caregiver has eyes on the patient but, if that care worker isn’t trained in drug therapy issues or does not have the health background training, they may not know the cause could be medication-related.”

She also noted that each person’s physiology is different and two drugs may affect only some people adversely.

“Someone might take two medications and have problems, while others won’t have an issue,” Levy said. “That’s what’s known as interpatient variability.”

Older adults are especially vulnerable to drug interactions because they tend to take multiple prescriptions, and some of those drugs have more significant side effects. Blood thinners and proton inhibitors are especially problematic, Levy said.

“I designed my book so that it is addresses the general problems with medications for older adults and strategies to take medications more safely,” she said. “We need medications to keep us going, and they can be very helpful in doing that, but if they are overused or used in the wrong combination or too high of a dose or for too long, these are all issues that they can actually hinder our ability to age in a healthy manner.”

Pill organizer to help patients stay on track, on time

Studies show that more than half of Americans don’t take their medications as prescribed by their doctors. 

That lack of adherence also results in nearly 125,000 premature deaths in the United States each year. The top reason cited by older adults is forgetfulness.

A pill organizer is one option to make sure a loved one is taking his or her medications correctly at the right time of day. Some pill organizers are smart devices and even dispense the pill. Their features include audible reminders to take the medications. The most sophisticated devices are automatic pill dispensers that notify the user, release the right amount of medication at a specific time, and even send a text or other notification to the patient and caregiver if the person misses a dose. 

5 key factors to consider when choosing a pill organizer include:

  • How easy it is to load?
  • Are buttons labeled with large displays and intuitive?
  • Will the device alert a caregiver when a dose is due or missed?
  • Can it hold large pills and
    accommodate multiple doses?
  • Does the device sit on a counter, or can it be carried?