The Prairie Doc Perspective

Poly-pharmacy and Aging (On medications and the elderly)

By Richard P. Holm M.D.

There are many words of medical advice to give seniors, such as “get regular exercise,” but there is one new recommendation that deserves notice, and that is to avoid “poly-pharmacy.” “Poly” means “many” or “excessive,” and pharmacy refers to medications and pills.

Avoiding poly-pharmacy is like the old adage, “Too many spices spoil the soup.” Along with the science that brings more effective medicine is the reality that sometimes taking too many medicines can cause problems. Multiple medicines mixed together may work differently than expected, compared to when used alone. Also, as the numbers of pills increase, side effects can multiply, costs can skyrocket, and people can get confused and make errors. All this goes double for the elderly. It is no wonder that experts in geriatrics are emphasizing the value of avoiding poly-pharmacy.

Poly-pharmacy happens because the patient expects the doctor to prescribe another pill; because the clinician is influenced by the patient’s wishes; because the doctor is trying to help the patient; or because certain protocols demand adding more medicines. And then there are all those herbal supplements. You know, some people have so many pills to take in the morning that there’s hardly room for breakfast.

It should be noted that the diagnoses of diabetes and congestive heart failure, for example, often require at least three medicines each. And people with multiple problems may need a lot of medicines, despite the best intentions of a skilled and conservative clinician. This is a very complex issue, which requires interaction from the patient and the best judgment from the doctor.

That being said, poly-pharmacy can result in problems and unnecessary expense. Be aware, and please talk to your doctor about this issue. Remember, too many spices can spoil the soup.

Dr. Rick Holm wrote this Prairie Doc Perspective for “On Call®,” a weekly program where medical professionals discuss health concerns for the general public.  “On Call®” is produced by the Healing Words Foundation in association with the South Dakota State University Journalism Department. “On Call®” airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain. Visit us at 

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