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Keep a check on the medicine cabinet


Keep a check on the medicine cabinet

Reliance on medicines becomes greater as we age, but there are risks. KENDALL MORTON explains the value of a Home Medicines Review.

Two in every three people over 65 take five or more medications, but the more you take, the more likely it is you’ll experience some negative interactions.

The Home Medicines Review is a free service set up by the Australian Government in 2001 to give people more knowledge and confidence about their medicines and to prevent medication-related problems.

If you are feeling unwell on your current medicines or they are not working effectively, a Home Medicines Review may help. Although the program is free it’s not that well known. Here’s how it works.

You can ask your GP for a referral. This is sent to a local pharmacist who will come to your home. He or she will ask questions, look at possible drug interactions and find out how you store your medicines.

They advise how to get the best from your medicines and answer questions. After the review, they will write a report for your doctor.  Here are six reasons a Home Medicines Review may be useful:

Avoid adverse drug reactions
An Australian report called Medication Safety in Australia 2013 found that 20-30 per cent of hospital admissions for people over 65 were medication related. In 12 per cent of cases, the adverse drug reaction (ADR) was considered life-threatening.

The drugs that most often caused ADRs were anti-bacterials, opioids, diuretics, antineoplastic agents, antithromboitcs and cardiac therapy. Some common adverse drug reactions were gastrointestinal bleeding, nausea, vomiting, hypotension, falls and arrhythmias.

Avoiding falls
Some medicines can cause swelling in the feet, rounding out the soles which can reduce your stability.  Other drugs may cause dizziness, sleeplessness and drowsiness. All of these factors increase risk of falling. Check the listed side effects of your medicines.

Harmful inactive ingredients
A report published in 2019 in Science Translational Medicine showed non-active ingredients such as dyes, sugars and lactose can sometimes trigger allergies or intolerances. Up to 75per cent of a tablet is made from fillers.

More than half of the drugs studied contained at least one FODMAP, short chain carbohydrates that are poorly absorbed in the small intestine. They have been linked to irritable bowel syndrome and other digestive problems.

Better communication
If you are under the care of many GPs and specialist doctors, a Home Medicines Review will give them all a comprehensive picture of your medications. If you have had a hospital stay that has led to a change of medication, a review is recommended.

Mood changes and depression
A report from the Harvard Medical School in 2015 showed many medications can bring on depression. The author Dr Laura Carr, a pharmacist at Massachusetts General Hospital noted “this side effect can be missed because sometimes patients hesitate to tell their doctor they are experiencing depression symptoms”.

One group of medicines, the benzodiazepines, need particular care. They are central nervous system depressants used to treat anxiety, seizures and insomnia. This group, which includes Xanax XR, Ativan, Librium and Valium, can build up in the body and lead to depression-like symptoms.

Dr Carr said older people were more likely to experience the residual effects of these drugs because their bodies metabolize medications more slowly.

Medications and dementia
A study by the Nursing Journal examined the effect of anticholinergic drugs. These drugs include antihistamines and some treatments for urinary tract infections, Parkinson’s disease and allergies. In older adults, anticholinergic drugs can cause confusion, memory loss, agitation and disorientation. These symptoms mimic early dementia.

This study took the drug history of 372 people over age 60 who did not have dementia for up to eight years and 80 per cent of those who had used anticholinergic drugs on a regular basis were found to have mild cognitive impairment.

For those individuals who were not regular users of this drug group, only 35 per cent developed cognitive impairment.

So, if you think a Home Medicines Review may be useful for you or a loved one, ask your doctor for a referral.

You can also speak to your local pharmacist or call the Pharmaceutical Benefits Scheme (PBS) information line on freecall 1800 020 613.

And just a reminder – Home Medicines Reviews are fully covered by Medicare.

 Kendall Morton is the Director of Home Care Assistance.

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