• ‘Polypharmacy’ is when a person takes five or more medications (including vitamins and over-the-counter drugs). (Pexels)Source: Pexels
If you have more than one chronic health condition, then you might be taking multiple medications over a long period of time. SBS asks whether polypharmacy is ruining or improving our health.
By
Alana Schetzer

20 Mar 2017 - 2:55 PM  UPDATED 20 Mar 2017 - 3:33 PM

The benefits of medication are undisputed - many illnesses that were once fatal or caused lifelong disability can now be prevented or easily treated. But that doesn’t mean that medication can always answer to every single health problem: we live in a society that tells us that every bump and cough can be treated by swallowing a tablet.

While some of us take medication occasionally, others are locked into long-term medication regimes for multiple chronic illnesses. According to 2014-15 statistics from the Australian Institute of Health and Welfare, one-in-four Australians have two or more chronic diseases, while one-in-three people aged 65 and over have three or more chronic diseases. 

This situation raises a serious question: how much medication is safe to take at once? 

From arthritis to back pain, asthma to cardiovascular disease and mental health conditions to diabetes, many Australians who endure multiple illnesses are taking multiple medications.

This situation raises a serious question: how much medication is safe to take at once? 

Dr Simon Bell, a researcher at Monash University's Centre for Medicine Use and Safety Pharmacy and Pharmaceutical Sciences, says taking multiple medications isn’t necessary a bad thing but that the more we take, the higher the risk of complications and possible dependence. And this depends entirely on which medications are being taken.

“Sometimes we do need to take multiple medications, although this could simply mean that you need to get a review from your doctor or pharmacist to make sure that [you are taking] the most effective approach [to managing your health],” Dr Bell tells SBS. 

'Polypharmacy' is when a person takes five or more medications (including vitamins and over-the-counter drugs). A 2012 research project published in The Medical Journal of Australia revealed that 43.3 per cent of Australians aged 50 or older take five more more medications. This can be harmless for some people, but cause problems in others.

Dr Bell says many medications are not designed to work together and, upon interaction, can cause side effects or cancel out each other’s benefit.

In the most serious cases in Victoria, prescription drug overdoses - intentional and accidental - is costing an increasing number of lives. In 2015, death from prescription deaths was far higher than those from illegal drugs, causing 330 deaths, as reported by the Victorian Coroner. These included Valium and codeine.

At the other, less serious end of the scale, the dependence on multiple medications can leave some people, especially young people, feeling frustrated, not to mention the ongoing costs, Dr Gnjidic says.

In 2015, death from prescription drugs was far higher than those from illegal drugs, causing 330 deaths, as reported by the Victorian Coroner. These included Valium and codeine.

Dr Danijela Gnjidic, a researcher in the Faculty of Pharmacy and Centre for Education and Research on Ageing at the University of Sydney, says there is often a belief that medication is the only treatment.

“But the problem is as things develop, we need to think whether it’s still needed or if it’s still effective," says Dr Gnjidic. 

Dr Bell says the issue with polypharmacy isn’t just a question of whether someone should take multiple medications because in many cases medication is vital, but when and if someone should stop.

“Often our clinical guidelines inform when we should start a medicine but don’t say how long it should be taken for or under what circumstances,” he says.

Every patient's circumstance is unique, so the question of how many medications a person should be taking concurrently difficult to answer, says Dr Bell. 

So, how do we know what medications are essential and which ones have an alternative available?

Every patient's circumstance is unique, so the question of how many medications a person should be taking concurrently difficult to answer, says Dr Bell. But, experts agree that we need to ask more questions.

The power dynamics between doctor and patient is one of the most uneven in the world - doctors, of course, have years of education and specialty training and we, the patients, trust that our doctors will use that knowledge to help us.

While it’s not a good idea to just randomly search for your symptoms online, which seems to always come up with cancer as the cause, Dr Bell says there are some reputable websites that can help patients navigate the complex world of health.

National Prescribing Service online is a really good site where people can get good information about medicines commonly used,” he says.

“The Internet can be a powerful tool for people to be more informed about the medicines that they take. It doesn’t replace the information you get from a doctor or pharmacist, but it can prepare you for asking the most helpful questions.”

Alongside regular reviews, Dr Gnjidic would like to see greater synergy between traditional medicine and holistic multidisciplinary treatments, so that complimentary medicines are investigated and taken under the guidance of a medical professional. 

“That would be ideal but that would require more time and effort from everyone involved,” Dr Gnjidic says. “People should consider speaking to their pharmacists more, too.

“We always advocate for people to talk to their doctors and question why they need to take something. That is a key point in which we can empower consumers.”

To find out more about the impact of taking multiple medications, watch 'The Doctor Who Gave Up Drugs' on SBS on Monday 20 March at 7.30pm and on SBS On Demand after airing. 

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