to consult with my H re the number of meds he takes each day. He takes (approx 15 different meds) for thr various chronic medical conditions he has. I have a strong suspicion that the cocktail is causing other problems.
What type of doctor, or other professional would I need to find? Is this a job for a pharmacist? Thank you - I’m not sure where to turn…
Who prescribes most of the meds? Family practice/internist? Or does he see specialists to manage the chronic conditions? A big problem with taking multiple meds ( including OTC) is the increased number or side effects and drug interactions, so probably some of the meds are prescribed to counteract the side effects rather than treat his conditions, but then these can create other side effects. Does he really take 15 per day?
I would start with your primary care or their PA if there is one. Tell them you want to potentially start backing out of some of the meds he is taking. If most of them come from the doc managing the chronic conditions, start there instead. It may be, though, that the mix he is taking is what he needs for maintenance.
If you are somewhat medical, make a spreadsheet and list them all. Record how much he takes, what it’s for, primary side effects. That might help you see what’s making things worse and what helps most. The Mayo Clinic website has excellent info for management of chronic conditions.
Does he have a primary care physician? I think that would be the place to start.
Are all of his meds get filled at the same pharmacy? If so, they would have checked for potential drug-drug interactions. If not, I would bring the list to the pharmacist you like the most and ask if there are any potential red flags brought up by the cocktail. Bring a list of your non-prescription stuff and supplements, too.
You GP should be able to answer the question, too.
I’m not a healthcare professional, but Google says the term is polypharmacy. This is just one resource:
Suggests pharmacists are underutilized for this issue. May be quickest to consult the pharmacist for their opinion, then maybe primary care or geriatrician.
Yes on the pharmacist. Prescribing doctors don’t know all that much about the drugs and especially about interactions and combinations. My aunt had dozens of meds and the pharmacist saved her from potential trouble a few times. Good luck.
I’ve found the best results with a pharmacist.
That’s about how many meds I’m on and once every 6 months or so, a pharmacist from my hospital system (University of Michigan) calls me to review my meds to make sure there aren’t side effects.
Do these all come from various specialists? I was able to consolidate my meds by switching to ones that can treat more than one condition (even though most of the time it’s off-label use). For example, I went from three meds - 2 heart and 1 (I think) anti-anxiety to 1 by finding a med that both controlled my heart and more or less was just as good for the anxiety. Try bringing this up to various specialists - they can review your meds and see if maybe they can switch some of the meds around.
Clinical pharmacist
I agree that a clinical pharmacist is your best resource. His doctor or health plan should be able to refer him to one.
How old is your husband? Is the same physician prescribing all of these medications?
Thanks, everyone.
To answer some questions:
H is a lightweight (145lb) 5’9’ 58y/o
Different physicians prescribing i.e neurologist / cardiologist / Internist & endocrinogist
Same pharmacy filling prescriptions
and thank you for the clinical pharmacist suggestions. That is exactly what I was looking for, but didn’t know it!
I have had great results with clinical pharmacists as well, plus my specialist who prescribed most of my Rx.
If the side effects are cognitive or psychological, a psychiatrist can help. A friend who’s a geriatric psychiatrist tells me 90% of his job is balancing the patient’s other meds.
+1 on clinical pharmacist. I’d be dead several times over if I took the meds various doctors prescribed, even though I give them a pre-printed list of my 13 daily meds plus vitamins and which specifically mentions side effects/contraindications. My new cardiologist hooked me up with an oncocardiologist who assesses the cardiac side effects of chemo drugs and interactions with other meds. I cried after my first appt with her – someone FINALLY got it.
Doctors generally don’t take nearly the number of pharmacology courses that pharmacists do! My oncocardiologist also teaches and says there is real resistance in the medical community that chemo has cardiac consequences. Many of them write off the cardiac issues to lifestyle and family history. Now that there are drugs that can turn previously fatal maladies into long-term chronic illnesses, there are new “late effect” sequelae to manage.
In addition to a pharmacy expert, does your DH have a primary? A good primary should be keeping an eye on this as well, although often they’re overworked and harried and won’t take a closer look unless specifically asked.