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Help doc, too much meds are making me sick (The New Paper, 6/11/2014)


By Lee Joon Lei

With diabetes, irregular heart rhythm and a fractured arm, Madan Zaiton Yahya once had to consult three doctors and a pharmacist, who each prescribed her different medications.

As there were too many of them - she needed a plastic tray to hold 13 types of medication - she forgot to take some and took others in large doses.

Madam Zaiton's case is an example of the growing trend of polypharmacy, which is a case of a patient, usually someone who is over the age of 65, having to take five or more types of medicine at a time.

This issue is covered in one of some 170 health-care-related studies submitted to the Alexandra Health Forum which begins today and runs till Saturday at Khoo Teck Puat Hospital (KTPH).

To highlight this problem, the hospital is trying to make both doctors and patients more aware of the need to communicate with each other so that they can reduce such cases.

Polypharmacy, while not always a bad thing, can cause patients to become confused or overwhelmed by the medicines they have to take daily. Interactions between various drugs can lead to side-effects such as dizziness, nausea and diarrhoea. It could even kill in serious cases.

Not taking her medications properly led to Madam Zaiton's blood pressure spiking, putting her at risk of developing a stroke.

The 64-year-old housewife has had Type-2 diabetes since 1985. Then, in late 2012, she fell at home and fractured her left arm. She also developed irregular heart rhythm in the same year.

Madam Zaiton was a patient of Tan Tock Seng Hospital until 2008, but she now visits only KTPH.

At KTPH, she saw Dr Doreen Tan Su Yin, who holds the posts of chief pharmacist, associate consultant and cardiology specialist pharmacist.

From Madam Zaiton's previous appointments, Dr Tan found that her patient had accumulated multiple strengths of the same medicine.

Dr Tan also realised that some of Madam Zaiton's medications were unnecesarry. For instance, she was still taking medicine for her fractured arm, which she no longer needed to.

Dr Tan worked with Madam Zaiton's doctors to remove the unnecessary drugs, cutting the total number she has to take to just seven.

And since the reduction of her medications, Madam Zaiton has not been admitted to the hospital. Previously, she was admitted five times to KTPH between 2011 to this year.

Madam Zaiton said that taking fewer medicines not only helps her remember the required dosages better, it also makes her feel more liberated.

She said: "I'm happier with having fewer medicines because it's a lot easier for me to remember which ones to take. It also makes me feel like I'm getting better."

Dr Tan believes that as ageing patients begin to have more medical conditions and have to see more doctors as a result, consolidation of care between these doctors is important.

She said: "There has to be more coordination between the various doctors of a patient to review the medicine given by each other, as well as those given by past doctors to see if any of the medicine given in the past are still needed."

Pharmacists play the role of consolidating the medicine lists of patients.

However, they would have to work closely with the various specialists to fine-tune that list further.

Dr Tan added: "It's good for doctors to be specialised in their various fields, but there needs to be more emphasis on the unification of a patient's care."

However, she maintained that patients also have a part to play in reviewing their medication with their doctors.

She said: "Patients should also be having conversations with their doctors at regular intervals about the medications they are taking and whether they can stop taking those which might no longer be necessary."


Source: The New Paper © Singapore Press Holdings Limited. Reproduced with permission.