Tips to help older people with medication use

The risks associated with medication usage increase as people age. Here – in the first of a two-part series – Dr Nirvana Luckraj shares some medication management advice.

There are for two main reasons as to why medication usage gets riskier as we get older. As we age, our bodies undergo numerous changes, including alterations in the amounts of water, fat, and muscle we possess.

Additionally, certain health conditions may contribute to further modifications in our bodies. These changes may result in increased sensitivity to medication, difficulty processing and eliminating medications, and increased susceptibility to side effects and medication interactions.

Furthermore, age-related changes to our brains and nerves may make it harder to manage medications, leading to problems such as memory loss or poor eyesight that affect our ability to take medications effectively. 

It is not uncommon for older individuals to take multiple medications, and taking five or more medications daily increases the likelihood of side effects and medication interactions.

To help prevent medication errors, it is advisable to speak with a pharmacist or doctor who can provide a blister pack or Webster pack to assist with managing medication schedules.

Additionally, any concerns about medications should be discussed with a healthcare professional, who may adjust the dose or prescribe alternative medications if necessary.

Importantly, individuals should never stop taking their medications without consulting a healthcare professional first. 

Questions that should be asked

It is important for older individuals to take an active role in their health and medications. Healthcare providers should consider the age-related factors that increase the risk of side effects or medication errors in their older patients, but it is also beneficial for individuals to ask relevant questions.

These questions could include inquiries about the purpose of the medication, potential side effects and what actions to take if they occur, options if the medication is not effective, necessary precautions, medication interactions, the need for regular monitoring tests, and ways to reduce the number of medications being taken. 

Digital tools such as the Question Builder can aid individuals in preparing a comprehensive list of questions to bring to their healthcare appointment, ensuring they are fully informed and equipped to make informed decisions about their medication regimen. 

The importance of regular medicine reviews

Maintaining good health involves proper management of medications, and carers and healthcare providers play a crucial role in this aspect.

To ensure effective medication management, it is recommended to establish a comprehensive medicines list that includes information such as the purpose of each medicine (prescription and non-prescription), its dose, and the proper usage. Keeping the list updated also helps to ensure regular review of the medications. 

For individuals taking multiple medications, it is essential to have regular medicines reviews – preferably every six to 12 months or whenever changes are made to the medication regimen.

These reviews provide an opportunity for patients and healthcare providers to discuss the medications and develop a joint medication management plan. In some cases, healthcare providers may arrange for a home medicines review to facilitate this process. 

Signs an older person may be on harmful medication

There are several signs that may indicate an older person is on harmful or unnecessary medication, including: 

• worsening of existing symptoms or development of new symptoms 
• unusual drowsiness or fatigue 
• confusion, disorientation, or memory loss 
• falls or unsteadiness 
• unusual weight gain or loss 
• unexpected changes in blood pressure 
• gastrointestinal symptoms such as nausea, vomiting, or constipation 
• skin reactions such as rashes, hives, or itching 
• unexpected changes in mood, behavior, or personality.

It is important for older individuals or their carers to closely monitor for these signs and to speak with their healthcare provider if any concerns arise. Regular medication reviews with a doctor or pharmacist can also help identify harmful or unnecessary medications. 

Avoiding adverse drug events

Adverse drug events can be avoided by taking several preventive measures, such as: 

• regular medication reviews with a healthcare provider can help identify and address potential ADEs and ensure that all medications are necessary, safe and effective
• keeping a complete and up-to-date list of all medications – this includes prescription, over the counter, and herbal medications – to avoid potential interactions and side effects 
• proper use of medications – following the recommended dosage, frequency, and route of administration, as well as taking medications at the same time every day, can help avoid ADEs 
• monitoring for side effects and reporting them promptly to a healthcare provider can help avoid or minimise harm from ADEs
• having a consistent healthcare provider and pharmacist helps avoid conflicting medication recommendations and improve communication and coordination of care
• avoiding unnecessary medications and opting for non-pharmacological alternatives, when possible, can reduce the risk of ADEs. 

Dr Nirvana Luckraj is chief medical officer at Healthdirect Australia, which provides 24/7 health information, advice and referral.

Next week, Dr Luckraj has more medication management tips.

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