Medication management for older adults

As we age, our bodies change. Some changes we can see and feel: aches and pains may linger and simple movements like walking or getting out of a chair may be slower or more painful than they used to be. Some we can’t, like how our bodies may change in how they respond to and absorb medicines. For example, according to the U.S. Food and Drug Administration and its medication guide for seniors, changes in the digestive system can affect how fast medicines enter the bloodstream.

Changes in body weight can influence the amount of medicine you need to take and how long it stays in your body. The circulation system may slow down, which can affect how fast drugs get to the liver and kidneys. The liver and kidneys also may work more slowly affecting the way a drug breaks down and is removed from the body. This means medicines may stay in the body longer and cause more severe side effects if doses are not properly adjusted and monitored. Because of these and other changes in our body as we age, there is also a higher risk of drug interactions in older adults.

Medicines & older adults: 10 important facts to know  

  1. Seniors use more medicines—prescription, over-the-counter (OTC) and supplements—than any other age group in the U.S.
  2. Older adults often use multiple medicines, increasing the risk of drug interactions, mix-ups and the potential for harmful side effects.
  3. Your liver and kidneys may not work as well as when you were younger. This decreased function can affect the way a medicine works, is absorbed, broken down and removed from the body.
  4. Medicines may stay in the body longer and cause more severe side effects if doses are not properly adjusted.
  5. Age-related changes to the body such as weight loss, decreased body fluid and increased fatty tissue can alter the way drugs are distributed and concentrated in the body.
  6. Increased sensitivity to many medicines is more common in older adults.
  7. Impaired memory and hearing and vision loss can make it more difficult to understand and remember medicine instructions, especially for those who have complicated treatment regimens. Many older Americans also face declining eyesight, grip strength, mobility and memory lapses—all of which can affect the ability to safely take medication as prescribed.
  8. Older adults tend to receive prescriptions from different healthcare professionals. This fact can make it more difficult to track medicines and identify drug interactions, harmful doses, and unnecessary or ineffective medicines.
  9. Chronic conditions such as diabetes, high blood pressure, arthritis, and cancer, are more common in older adults and often require a more complex medicine management regimen.
  10. Older adults may not follow medication plans because of forgetfulness, bothersome side effects, a perception that the medicine isn’t working, and/or the cost. Not following instructions or treatment plans, associated with medicines is called non-adherence.

The good news is, many of these risks or challenges can be prevented if you are armed with information about safe and appropriate medication use and how to get the most from your medications.

Medicines & older adults: tips to avoid and prevent problems 

  1. Learn about your health conditions and the medicines you take. Talk with your healthcare providers, read trustworthy online sites, join health support groups. You are your own best advocate and champion when it comes to your health, and knowledge about your own self-care is key.
  2. Make and maintain a medication list that includes:
    • Names of all medications you use, including any OTCs, dietary supplements and herbal remedies
    • The healthcare provider who prescribed each Rx medication
    • The purpose of each medication or the symptoms the medication is supposed to treat
    • How often and at what dose (amount) you take each
    • Whether refills are needed

    Be sure to update the list when you start taking something new or if a medicine is stopped or if your healthcare professional changes the dosage strength. Your primary care provider should review all of your medications regularly to make sure you are only taking those you need. Remind him or her of any allergies or problems you’ve had with certain medicines. Don’t stop taking prescribed medicine without checking with him/her first.

  3. Be sure to read the Drug Facts label (found on all OTC packages), package inserts or Patient Medicine Information leaflets (provided with your prescription medicine(s)) when starting a new medication. These can provide important information to help you get the best results and avoid problems. These tell you:
    • What your medicine is used for
    • How to take your medicine correctly (how often you should take it and at what amount or dosage)
    • Possible side effects or allergic reactions to watch out for
    • Warnings including who shouldn’t take the medicine, when to stop use and ask a doctor, who is at increased risks of side effects
    • Storage instructions
  4.  Use one pharmacy so that your prescription records are all in one place. This enables your pharmacist to regularly monitor the medications you take and let you know about potential drug interactions.
  5. Safely store medicines. Check expiration dates. Keep all medications in the bottle, box or tube that they came in so the dosage and directions are always close at hand. Keep medicines up and away and out of sight of pets and when grandchildren come to visit. Never share your prescription medicines or take others’ medications. (Visit our medicine storage and disposal page for more information.)
  6. Contact your healthcare provider if you have any problems with your medicine. There are no “stupid questions” and no question is too trivial when it comes to your health and your medicines.
  7. Identify a “patient navigator” within your healthcare team to help navigate the healthcare system and take prescription medicines as prescribed. This is especially important for older adults suffering from multiple chronic conditions. Ask your primary care physician to act as your advocate, or “navigator” through the health system. That way, one person or practice will be responsible for ensuring that all of your chronic conditions and treatment regimens are being tracked and addressed. Under Medicare’s Medication Therapy Management (MTM) Program, pharmacists or other healthcare professionals can fulfill this patient navigation role. Consider this option as well.