Millions of people taking commonly prescribed medicines for conditions such as high blood pressure, diabetes and high cholesterol have been warned about the potential risks of using multiple drugs over many years. Dr Amir Khan has voiced concerns about overprescribing and the side effects experienced by patients taking combinations that may include statins, ramipril and metformin. The GP said more than eight million people are currently taking at least five medicines, while hundreds of thousands are taking 10 or more. He warned that this widespread use of multiple medications, known as polypharmacy, is contributing to hospital admissions linked to drug side effects.
“It’s resulting in about a thousand hospital admissions due to side effects of medication,” Dr Khan said. “Now we do have a term for this. It’s called polypharmacy.
“Anyone who’s on five medications or more is called polypharmacy. It’s not automatically a bad thing because lots of people are on medication that is keeping them alive and well.”
Dr Khan stressed that patients should never stop taking prescribed medicines without first speaking to a doctor, pharmacist or another healthcare professional. He explained that people who began treatment for high blood pressure, diabetes or heart problems in their 50s or 60s may continue taking the same prescriptions decades later, even though their health and circumstances may have changed.
“The problem we have is that often people start these medications in their 50s and 60s and are still on them in their 80s as well,” he said.
“So the prescription stays the same, but the person has changed over that time. Their kidney function may have changed, their weight may have changed, their liver function. All of these things that drugs rely on to break down and work could have changed, resulting in more side effects. And that’s the issue.”
The doctor also cautioned that medicine side effects can sometimes be mistaken for new illnesses. In some cases, this may lead to further prescriptions being added rather than the original medication being reviewed.
Older people may be especially vulnerable, Dr Khan said. Symptoms caused by medicines they are already taking can be treated as separate health problems, resulting in additional tablets instead of recognition that the symptoms may be side effects.
Dr Khan said: “So the other thing is older people are more prone to these side effects. They come in and see doctors and, rather than saying this is a side effect of the medication, they treat it as a new illness and get a new tablet for it as well.
“And they could be under a specialist who gives them another tablet for that.”
He said a more coordinated approach is needed, with doctors and pharmacists considering a patient’s overall health and regularly reviewing whether each medicine is still necessary.
Dr Khan referred to this process as “deprescribing”. It involves carefully reviewing a person’s medication and, where appropriate, stopping medicines that are no longer needed.
“But I think the key people to do all of this are pharmacists in GP surgeries. We’re getting more and more of them. They are brilliant at looking at which medications need to stay on and which ones can come off,” he said.
