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The Hazards of Pill Juggling

Here is a startling statistic: Medication related problems are believed to be the fifth most common cause of death in the U.S. Incredibly, the problem seems to be getting worse.

A big part of the danger stems from “polypharmacy.” That’s the term used to describe that situation, particularly acute among older people, where we find ourselves juggling a lot of meds on a daily basis. Older people with dementia frequently rely upon family members or other caregivers to manage their medication, and often these caregivers have their own medication to manage as well.

Who can keep track of all these pills?

"The patient themselves may make mistakes, taking the wrong pill or dosage. And where responsibility for looking after medication moves to a family carer, they may find this role a burden. We need to find a way to make this safer and easier, based on what we can learn from the experiences of patients, carers and practitioners, and from good evidence of what works well," said Dr. Ian Maidment. He has undertaken to lead a team of researchers at Aston University in the U.K. to find a solution. The project is titled MEMORABLE – Medication Management in Older People: Realist Approaches Based on Literature and Evaluation.

The researchers will examine the existing scientific evidence as well as interview older people, caregivers, and health and care practitioners to learn from their experiences.

Dr. Maidment said: "With an aging population, this problem is very likely to get worse. More people will require medication for long term conditions and the responsibility for helping those patients manage their drugs will frequently fall on older carers, who will often have their own medications to deal with as well.”

A third of people aged 75 years of age or over regularly take six or more medicines and it is predicted that up to three million people will be regularly taking multiple medicines within the next year.

Polypharmacy can happen when patients move between care providers, or when the side effects of one drug are treated as if they are a new medical condition, rather than a side-effect.

"The patient themselves may make mistakes, taking the wrong pill or dosage,” Maidment said. “And where responsibility for looking after medication moves to a family carer, they may find this role a burden. We need to find a way to make this safer and easier, based on what we can learn from the experiences of patients, carers and practitioners, and from good evidence of what works well. That's what makes this study novel."

More information on the MEMORABLE project can be found in the Journals Library of the National Institute for Health Research.