Polypharmacy: How to Reduce Drug Consumption

Polypharmacy: One-third of older adults consume more than five medications a day. How can we reduce medication abuse and increase prevention?

di |
drug abuse in Italy

POLYPHARMACY

La polypharmacy, or excessive medication use, with its attendant waste, is a common problem in Western countries, but in Italy it has reached truly alarming proportions. In our country, 30 percent of seniors between the ages of 75 and 85 regularly take five or more medications a day; 11 percent take ten or more medications. Thus, even in Italy, talk of deprescribing is beginning, which involves gradually reducing the use of medications, following the patient's therapeutic pathway. This approach does not compromise the treatment's results, but rather strengthens them, as medications wasted due to excessive use risk producing the opposite effect.

Lo waste of medicines It arises from the combination of several factors: we will have to buy them even when we don't need them; we have become masters of self-prescription, we get the dosages wrongEither with too low doses or with overdose: two ways to make the use of the medicine useless.

PHARMACEUTICAL EXPENDITURE IN ITALY

Pharmaceutical spending, dominated by market forces and lacking transparent information, continues to grow. Driven by the increase in prescriptions, it reached €23,5 billion in 2022, and has already increased by 5 percent in the first nine months of 2023. Medicines, which Italians buy like candy at the tobacconist's, account for 18 percent of the total budget. National Health Service.

DRUG ABUSE

A poor mother, faced with aotitis daughter had the (wrong) idea of ​​asking for a antibiotic to the pharmacist. In turn, the pharmacist made the right (mistakenly) decision, as if he were a doctor, to prescribe a very high dose of antibiotics. At that point, the mother, frightened by the excessive prescription, closed the loop by calling the doctor, who (another mistake) resolved the situation over the phone by telling her to lower the dose.

It is a true story, not a journalistic invention: one of the many true stories that are being consumed in Italy, adding up mistakes, waste and small or large speculations, around the theme of the abuse of drugsAnd in particular antibiotics which, let us remember, become completely ineffective if used improperly.

Drug abuse in Italy, waste, health risks, self-prescription medicines for young people

ALSO READ: How to use antibiotics: 10 rules for avoiding waste and making them effective.

DRUGS AND THE ELDERLY

The largest consumers of medicines are the elderly: nearly 70 percent of national pharmaceutical spending is for men and women over 65. This figure is only partially explained by the fact that some diseases become chronic as we age. This enormous consumption of medicines by the elderly is a source of enormous waste, fueled in part by unscrupulous doctors and the neglect of prevention and the simple, basic good habits that could at least stabilize a chronic disease without resorting to drugs. No scientific research demonstrates that 15 medicines (many elderly people take this daily dose, according to a "Reposi" study) are more effective than 10, while they undoubtedly increase side effects exponentially. Finally, at 80 years of age, it's unlikely that a medicine for a chronic disease will truly help a patient.

PURCHASE MEDICINES WITHOUT A MEDICAL PRESCRIPTION

This story is also a paradigm of which and how many wrong connections must be broken to break the chain of waste. drugs, which has a significant impact on family wallets, on public spending (the cost of the National Health Service) and, above all, on people's health, starting with children. The World Health Organization, just to evoke a number, predicts 10 million deaths, by 2050, due to resistance to antibiotics.

HOW TO REDUCE DRUG CONSUMPTION

There are many ways to reduce drug purchases, which today are no longer considered medical products but rather consumer goods in the broadest sense. Here are some examples of what can be done, also based on the recommendations of Professor Silvio Garattini, Italy's leading expert on this subject:
  • Rationalize the prescriptions and provide medication when needed
  • Revise the list of reimbursable medicines, where currently 70 percent of the drugs dispensed by the National Health Service are copies of other medicines or are even useless.
  • Increase prevention
  • Prevent the use of interacting drugs
  • Unify medical records

TO KNOW MORE: How to dispose of expired medicines and avoid wasting those you no longer need

HOW TO READ MEDICATION PACKAGE LEAFLETS

To avoid wasting medicines, whose consumption in Italy has increased by 60 percent since 2000, we must first put an end to self-prescriptions. It's incredible how even today the 40 percent of people between 25 and 34 years old, mature people, can take medicines and antibiotics without going through a doctor. Secondly the "leaflets" of the Medicines they must all be returned, and not just some, clearer and more readableIt's unrealistic to think that a consumer needs a couple of degrees, one in Pharmacy and one in Mathematics, to understand these indecipherable texts. Third, to simplify matters, as suggested by the Mario Negri Institute in Milan, we need to create comprehensible tables that precisely indicate the amount of medication in proportion to the patient's weight. And if possible, they should be consistent and, once again, comprehensible: pharmacists themselves point out the confusion surrounding the units of measurement for medications, sometimes expressed in mg (milligrams) and other times in ml (milliliters). Is it really that much to standardize administration and avoid dangerous confusion?

HOW TO TAKE MEDICINES

To take the medicine in the correct and effective way, once the medical health insurance company has given his therapeutic indications, there are two things to respect, as if we were soldiers rather than patients. The established dosage, and the administration timesIf the dose of the medicine is too low, then the drug is ineffective and becomes useless. If it is too high, side effects are likely to occur. Two mistakes, two risks, two wastes. If we consider that 54 percent of the errors of the dosage occurs at the time of administration, then it becomes clear that the blame for this waste lies with us, not with the doctor or pharmacist. As another statistic confirms: 6 percent of hospital admissions are related to errors in medication use and dosage.

DOSAGE OF MEDICINES

To respect the dosage of your medicines, remember some important things:
  • Clarify the timing, quantity, and method of administration with your doctor. Don't be vague and don't rely too much on the for successful corporate training, often illegible
  • If there is something you want to change, for example you think the pills are too big, ask your doctor for permission to change the formulation of your therapy.
  • The therapy lasts for the time indicated by the doctor. It does not stop before or after, unless the doctor decides otherwise.
  • Write the dosage and time of administration in a clearly visible place, perhaps on the medicine box.
  • Preserved medicines correctly
  • Do not double the next dose if you miss one due to a simple oversight.
  • Always ask your doctor if there are any contraindications between the prescribed medicine, with its dosage, and any foods or drinks

DRUGS AND SPECULATIONS, WHAT YOU NEED TO KNOW:

Want to see a selection of our news?

Don't Waste