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Friday, March 21, 2014

Do your medicines get along?

When we get into our senior years, chances are we’ll be regularly taking medications, either as a treatment or as a preventative measure for chronic ailments. Unfortunately, the chances that some of those drugs will interfere with each other is quite high. Researchers from the Yale School of Medicine found that about a fifth of older Americans receive medications that can worsen some of their conditions.

About 75% of older adults have more than one treatable chronic condition. For example, a person might have high blood pressure (hypertension) and diabetes. The medications for some ailments can be detrimental for other conditions. Beta blockers taken to treat heart disease can worsen pulmonary disease.

To look for drug interactions, the scientists recruited close to 6000 medicare recipients, who provided health and medication histories. Fourteen different ailments (hypertension, osteoporosis, etc) treated by 27 different classes of medication were included in the study.

Nearly 80% of the participants had at least two chronic conditions and almost a third of the patients had ten different conditions! Given those statistics, it’s not at all surprising that that 23% of the patients were receiving at least one medication that could have worsened one of their conditions. And that doesn’t even include nonprescription medications like aspirin.

The matter is complicated by the fact that patients may be better off taking two competing medications that are only somewhat effective than in skipping the treatment for one of their medical conditions. This makes it even more critical to be sure that your doctor knows all the medications you are taking so he or she can evaluate the cost/benefit of them in combination.

Lorgunpai, S., Grammas, M., Lee, D., McAvay, G., Charpentier, P., & Tinetti, M. (2014). Potential Therapeutic Competition in Community-Living Older Adults in the U.S.: Use of Medications That May Adversely Affect a Coexisting Condition PLoS ONE, 9 (2) DOI: 10.1371/journal.pone.0089447.

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