Only a third of older Americans who take at least one prescription medicine every day have spoken to a healthcare professional about possible drug interactions.
Older people tend to be living with multiple health conditions, meaning they may be taking several prescription medications at once. This places them at risk of drug interactions, either between different prescriptions, or prescribed medications and over-the-counter drugs or supplements.
The impact of such interactions can range from low blood sugar or kidney damage, to accidents caused by drowsiness or fatigue.
Electronic health records (EHR) have been developed with built in alerts to reduce this risk. However, they are certain limitations when it comes to the way people access their medicine.
The University of Michigan ran an online survey in April 2017. The report is based on the responses of 1,690 US adults aged between 50 and 80, who were asked about beliefs and experiences related to prescription medications and drug interactions.
Almost all, 90%, of older adults said they were confident that they knew how to avoid drug interactions, yet only 35% had spoken to a healthcare professional about it. Of these, 75% had spoken to a doctor, 60% to a pharmacist and 14% to a nurse.
Of those surveyed, 63% said they took two or more prescription medications, and 16% said they took six or more. Just over one-fifth, 21%, said they had used more than one pharmacy, including retail and mail order, in the last two years.
When asked how they selected a pharmacy, 29% said they based their decision on price and 81% said convenience. Most (79%) said online and mail order pharmacies were about the same in terms of medication quality.
The survey asked which type of pharmacy better helped older adults understand how to take their medication. Half of respondents said they thought retail and mail-order pharmacies were equivalent, whereas 48% said retail outlets were better.
It also asked who they thought was responsible for explaining possible drug interactions, and 11% said the pharmacist. Just over one quarter, 26%, said the doctor and 63% said the pharmacist and doctor were equally responsible.
Researchers said the conversation was complicated by people using multiple pharmacies, as well as seeing multiple doctors, as was true in 69% of those surveyed. Just 36% of people said the pharmacist definitely knew all the medications they were on.
The expansion of EHRs may reduce the risk of drug interactions, but there is still a challenge regarding people using multiple pharmacies to fill their prescriptions. Providers may not share information, meaning alert systems will be less accurate. In addition, these systems may not include information on over-the-counter medications and supplements, some of which could pose a risk.
The study authors said older adults needed to be proactive partners in avoiding drug interactions. To do this, they should take an up-to-date list of prescription and non-prescription medications, including supplements and vitamins, to medical appointments.
Healthcare professionals should explain the importance of reviewing medications to their patients and provide specific counseling on what to do in the case of a possible medication-related problem, they added.
University of Michigan National Poll on Healthy. December 2017 Report: Drug Interactions – How to Avoid Them. Available at: https://www.healthyagingpoll.org/report/december-2017-report-drug-interactions-how-avoid-them (accessed December 12).