WHAT ARE THE SIGNS THAT WE SHOULD RELOOK A SENIOR’S MEDICATIONS?
“Some red flags include recurrent falls, excessive drowsiness, new confusion or worsening memory, constipation, low blood sugar levels or frequent hospital admissions,” said Thurga. “Families sometimes attribute these symptoms to ‘old age’ when medications may be contributing factors.”
Huang added that a change in blood pressure and/or heart rate may also be an indication. “One challenge is that (new) medication side effects can sometimes be mistaken for a new illness,” he said. The caregiver may assume cognitive decline to be the cause but the underlying problem could partly be medication related.
“This is why we should pay attention to when a symptom started and whether it coincided with a new medicine, a change in dosage, or the addition of another medication,” said Huang. However, it would be prudent to have the situation assessed by the doctor or pharmacist – and not stop the medication, he emphasised.
HOW OFTEN SHOULD WE REASSESS A SENIOR’S MEDICATIONS?
“A full medication review should take place at least once a year for patients on multiple long-term medications, and more frequently after a hospitalisation or significant change in condition,” said Assoc Prof Chew. “Discharge from hospital is a particularly critical moment as new medications are sometimes added during a stay without older ones being reviewed or removed.”
Dr Tay said that “there is no single review interval that suits everyone”. In diabetic patients, “we found that patients who received two reviews achieved better diabetes control compared with those who received just one review over six months”, she said, citing a study by NHG Pharmacy.
“While these findings are preliminary, they suggest that medication reviews need not be a once-off exercise,” said Dr Tay. “For patients with complex medication regimens, two or more medication reviews a year may be a reasonable approach, particularly where there are ongoing issues with diabetes control or medication changes.”
