The BBC recently carried an article by Helen Santoro on 9 September which came from Knowable Magazine. It is about the growing trend for “polypharmacy”, which is where patients, often elderly but certainly not unknown among younger people, take multiple medications for different conditions every day.  It is usually defined as taking 5 or more different medications a day.

No-one really LIKES having to take multiple medications, but sometimes it is necessary.

However, there is beginning to be some evidence that in some cases, this could be a mistake, or counter-productive.

Before going any further, we must be clear that we are lawyers, not doctors and we would NEVER suggest that any changes to medication or treatment should be undertaken without consulting your GP, obtaining their advice and only making changes approved and monitored by them.

For many people, trying to keep up with the number of tablets and to take them at the right time can be a bit of a struggle and could lead to missed medications, leading to a resurgence of symptoms, or even overdoses of the drugs if there is some confusion over which ones they are. A lot of drugs are the same colour and a similar shape, so it’s easily done.

This may be especially so for elderly people suffering with confusion issues, those for whom English is not a first language, those who are blind or partially sighted and people who may be dyslexic.

It can also mean that patients just end up being too confused and abandon their medication, thus potentially haring their health and at the same time, wasting medication costs for the NHS.

If they could take fewer tablets, then this may make it easier for them to take the remaining ones correctly.

Our clinical negligence team at Ringrose see several cases of the wrong medications being handed out at pharmacies because of similar packaging for different drugs, or different doses of the same drug. Fortunately, this becomes noticed after a fairly short time because the client/patient realises something is not right.  They often get an adverse response which they hadn’t noticed before and so check their medication. Quite often, it’s a family member or carer who spots it.

But the consequences of the wrong medication, or mixed with an incompatible drug can be serious.

How to solve the problem?

Medical and pharmacy courses tend not to consider “de-prescribing” medication once prescribed.  But common conditions such as high blood pressure and Type 2 diabetes can respond well to lifestyle changes and sometimes settle that way.

Dr Tobias Dreischulte, who is a clinical pharmacist at Ludwig Maximilian University in Germany says:

“You need the discussion to check whether the balance of harms and benefits is constant over time,”

But he also did earlier research at the University of Dundee in Scotland and is part of a team that published a series of guidelines in 2012 to help country’s doctors and pharmacists reduce the use of unnecessary or potentially dangerous medications.  They seem to have been effective in reducing problems with medications.

It is however, a growing problem. People age and chronic medical conditions such as osteoporosis, cardiovascular disease and cancer, become more common. For many, prescribing drugs is the almost automatic method of treating these illnesses. According to a report by the Lown Institute, a non-profit think tank, 42% of all older adults in the US take five or more prescription medications a day and almost 20% take 10 drugs or more.

The profit motive for prescribing drugs is sometimes cited as a reason why this is happening, but we don’t deny that there are a significant number of people whose life depends on a medication routine.  The pharmaceutical companies also do a lot of expensive research which benefits everyone while developing their products.

There could in fact be a much simpler reason-lack of communication.  This could be between patient and doctor, or doctor and doctor, as with some conditions there are differing views on management, especially across different medical disciplines.  This is not saying that only one doctor must be right. Far from it. There are often a range of treatments and medication and it is down to the doctor’s clinical skill and judgment to decide on what is best for THAT individual patient.

Just because something turns out not to have been right for a particular patient is not evidence of negligence, unless it is something that no reasonable doctor would have done , or not done.  Sometimes different things have to be tried before finding the right regime.

Patients do seem open to trying to reduce medications.  In 2018,  survey suggested that 92% of older adults in the US are willing to stop taking one or more of their medications if their doctor says it’s possible.

There is a lot more we could say on this subject, but our tips are these:

  • To help yourself, ALWAYS check that you have been given the correct medication while in the dispensing outlet. If you have any doubts at all, ask the dispenser, who may be the pharmacist or at the doctor’s surgery.
  • Check that the dose is correct.
  • If the box or tablets look different, again, check. Packaging and shape of tablets do change or you might have been given the correct medication under a different brand.
  • If you are a parent, looking after elderly parents or someone under a disability or a professional carer, you may need to do the checking for the patient.
  • If you get any unusual symptoms, feel “different” or may be vomiting, check back with your GP immediately or call or go back to the dispensary outlet.
  • If you notice anything different about someone you know or look after, make sure they get the medication checked or do it yourself with the GP or dispenser.
  • If necessary and all else has failed, go to A&E.
  • Make sure you have a list of all other medications you or another person is on, or whether they are having any treatment, such as chemotherapy. It could be that a drug is interacting with the medication.
  • Check whether they could have taken too much of one medicine/tablet, or not enough. You can get little boxes with the days of the week or even times of day on and these can be useful for putting the correct dosages in for the correct day and time.
  • The sooner you can act, the sooner the mistake (if it is one) can be rectified.

We can help

If you have been prescribed the wrong medication and it has resulted in a deterioration of your health we can help. Contact the Medical Negligence team at Ringrose Law on 01522 561020 or email wecanhelp@ringroselaw.co.uk 

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