Too many pills adding to physical and psychological burden of seniors

Nagpur: Advanced age brings many physiological and psychological complications and Covid has only made them worse. Already dependent upon a variety of medications, post-Covid complications have now added to the list aggravating the situation doctors call ‘polypharmacy’.
While some consider ‘polypharmacy’ a bane, others feel there is no option but to address the health issues with adequate medicines to save life. Amid the raging debate revolving polypharmacy, psychiatrists feel the senior citizens need much care and love especially from the caregivers at home.
Dr Nitin Gupta, consultant primary care physician, diabetologist and also specially trained for geriatric complications, said elderly seemed to have faced the worst during Covid pandemic with loss of life, spouse and also much worse health complications than others. “I am seeing many elderly patients whose sugar level have shot up post-Covid. They are also facing problems like pulmonary fibrosis among others,” said Dr Gupta.
“All these complications have increased their medications manifold which has just added on to the treatments already on. This is leading almost all elderly patients to polypharmacy,” he said. “It has become difficult for them to take almost 20-25 or even more pills per day without getting confused and making mistakes,” said the physician based on his recent experiences.
Dr Gupta added polypharmacy was not only adding to the ‘pill burden’ but also aggravating the ‘bill burden’. “The standardization of the discharge prescriptions without or with minimum individualization is one of the reasons behind polypharmacy. I am trying to modify their prescriptions, cut down on the drugs having similar actions, adding fruits and vegetables instead of multivitamins or immune-boosters and suggesting yoga, pranayama and aerobics instead as much as possible,” said Dr Gupta.
Physician Dr Sharad Deshmukh, who has been treating many seniors, stated the multiple guidelines of the government, different medical and research bodies were responsible for polypharmacy as each of the protocol has its own therapies that doctors try to follow. “Though there is low evidence of efficacy, still their usage is wide and rampant. The most common misuse of drugs is that of the antibiotics,” he said.
Dr Deshmukh added psychological disturbances were most prevalent in the elderly after Covid. “Many times, the elderly patients are scared of heart diseases and come with complaints of breathing difficulty, shortness of breath but without many physiological reasons. The cause seems psychological or anxiety,” he said adding that headaches, loss of odour, abdominal issues and respiratory damages are common.
Noted physician Dr Nikhil Balankhe argued that polypharmacy was required to fight multiple post-Covid symptoms and complications. “Most geriatric patients have many comorbidities that must be addressed simultaneously. Their immune power or resistance is low. Hence, gravity of post-Covid complications is bigger,” he said.
“Some elderly patients may get confused with drugs due to dementia but all those prescribed drugs are important to tackle life-threatening conditions,” said Dr Balankhe.
Well-known psychiatrist Dr Sudhir Bhave said the caregivers must be more sympathetic and compassionate. “Acceptance is the key. I counsel the senior citizens to accept the fact that they would need certain medicines though too many of them have side-effects but the optimum use cannot be ignored,” he said.