While we are fortunate to be living in a modern world that is constantly making advancements in the field of medicine, the side effects of pharmaceuticals can often be dangerous and have implications that must be assessed. The March issue of the Journal of American Medical Directors published an article titled “Exploring Variation in Rates of Polypharmacy Across Long Term Care Homes.” The study on polypharmacy, which the article defines as “the use of multiple, concurrent drug therapies” produced startling results on just how many medications nursing home residents today are taking on average.
If a patient was on nine or more drug regimes at once, the study considered this a practice of polypharmacy and compared the quality of life of these patients to those who were taking fewer medications. The study found that patients subject to polypharmacy were more likely to have comorbidities. This group comprised about 15.5% of nursing home patients taking nine or more drugs simultaneously. Only 2.9% of patients were taking no drugs, and the remaining 81.6% were using anywhere between one and eight drugs at once. The most commonly used drugs include diuretics, proton pump inhibitors, and enzyme inhibitors.
Additionally, the study noted that in general, psychoactive drugs are also one of the most frequently used drugs in nursing homes. Previous studies have established that psychoactive drugs, although intended for treatment of illnesses such as schizophrenia, are often administered to patients who suffer from dementia. Because dementia patients may have episodes of agitation, nursing homes often find it convenient to sedate these residents with psychoactive drugs in order to prevent these episodes from occurring. However, this improper use of pharmaceuticals is an example of a chemical restraint and is in direct violation with the Patients’ Bill of Rights. Furthermore, studies have concluded that the use of psychoactive drugs in dementia patients has reciprocal effects and can actually cause agitation and worsen the overall condition of the patient.
In addition to triggering agitation in dementia patients, drug use can also cause delirium. It is important that you monitor your loved one’s drug intake, as well as the staff that is administering these drugs to him or her. Sometimes, understaffing and disorganization among staff can lead to mix-ups between patients’ drugs. Taking another patient’s drugs can have detrimental effects on health, and may even cause death. The study also noted that the more prescribing physicians a patient had, the more likely polypharmacy was to occur. This can be attributed to that fact that care facilities may not be properly documenting medical records. In terms of administration and management, documentation of medical charts is extremely important. All attending physicians must be able to clearly and easily see every medication that a patient is taking, in order to assess the costs and benefits of prescribing additional drugs.
Unfortunately, not all skilled nursing facilities have your loved one’s best interests at heart. What you can do is make frequent visits to check up on your loved one’s health and well-being. It is recommended that you have a general awareness of medications that are more likely to cause adverse drug reactions and overdoses. Also ensure to assess the facility’s staffing levels and closely monitor nurses, because tampering with patients’ drugs can sometimes occur in healthcare facilities.