risk of pathologizing life

The inappropriate polypharmacy It is a public health problem, recognized even by the Ministry of Health itselfwhich affects. especially, to the elderly.

According to the report Use of chronic drugs in polymedicated people aged 65 and over and its relationship with morbidityfrom the Ministry of Health, about three out of every 10 people over 65 years of age take at least five pills on a recurring basis and they do not always need all of them.

Specifically, the reasons that explain part of this polypharmacy – in addition to, of course, a higher prevalence of chronic diseases in these age groups – have to do with system failures or defects, that could be corrected.

From Health they relate inappropriate consumption with cascade prescription To mitigate side effects of drugs, lack of periodic review, the self-medication, he use of alternative remedies, the Fattention ragmentation and the Fhigh longitudinality.

Psychotropic drugs

And among the medications that are overprescribed, adds the psychiatrist, psychoanalyst, member of the Health Expert Committee of 65AND MORE and president of the Section of Psychiatrists of the Official College of Physicians of Barcelona, Josep Moya Olleit must be put a special emphasis on psychotropic drugs: According to the Health report, around 30% of polymedicated seniors consume chronically antidepressants, anxiolytics or hypnotics.

In this case, he argues, more pills than necessary would also be prescribed. “We live in a society that rejects physical pain, anxiety, sadness, that is, mental suffering and fundamentally everything that is related to aging”, comments.

And he warns of a dangerous and growing tendency to “pathologize the discomforts inherent to life,” as, for example, when “perlet’s give loved ones, status, purchasing power, purchasing power, health…” during old age.

And, he affirms, although it is logical that these losses are experienced with regret and painthis should not necessarily mean that “take antidepressants”.

Excess recipes and risks

Furthermore, the cultural inability to tolerate the discomfort, He adds, other factors that encourage polypharmacy should be added, such as a medical system that encourages excess recipes wave reduction of thresholds that define the disease.

During his long professional career, Moya has been able to see with his own eyes the effects of inadequate polypharmacy. He recalls a case in which he discovered that a patient’s risk of falling was due to consumption of diazepam combined with other drugs against pain.

It is worth remembering that, as the Health Department has warned 65AND MOREthe consequences of taking more drugs than necessary can be serious. “Some drugs such as benzodiazepines, anti-inflammatories or anticholinergics are associated with a greater risk of falls, confusion or cognitive impairment,” they confirm. “The potentially inappropriate prescription (PPI) in Spanish multicenter studies reaches up to 33% in people over 64 years of age and is associated with a 91% increase in hospital admissions due to adverse events, 60%, in functional deterioration and, 26%, in adverse reactions, being more frequent in people who live in residences”, they state and list the potential dangers: drug interactions, andadverse effects, ddifficulty in complying with treatment correctly, disdecreased adhesion, andmedication errors and dfunctional and cognitive deterioration in older people, increasing the risk of fragility.

More time, more listening and fewer recipes

For all these reasons, compared to the inertia of prescribing a pill for each physical or emotional symptom, Josep Moya Olle defends that true transformation must occur in consultations.

The objective should be, he believes, that the elderly patient can leave the outpatient clinic without necessarily having to have “a recipe in your hands.”

And to achieve this, he points out, it is imperative to allow more time for visits. Specifically, he suggests, doctors, nurses, physiotherapists and psychologists need real space to be able to simply listen to the person in front of them.

This would result, he predicts, in avoiding many unnecessary prescriptions for, for example, “insomnia, nostalgia” or other daily discomforts linked to this vital stage. A recipe, based on words and time, that not only would drastically minimize polypharmacy and the risk of fatal falls, but it would be a direct way to reduce costs and guarantee the survival of the health system, he concludes.