More than 2 in 5 seniors experience polypharmacy, meaning they are prescribed five or more drugs. Polypharmacy is a persistent issue in elder care, particularly for patients with chronic or advanced disease. The medication burden increases as patients near the end of life, with an average of more than 10 drugs per patient. As a pharmacist serving the hospice community, I often find myself asking a simple question: Is this medication treating a symptom or a side effect?
As children, many of us sang the song about the old lady who swallowed a fly. She swallowed a spider to catch the fly, a bird to catch the spider and so on. That silly song illustrates the concept of a prescribing cascade, in which medications are prescribed to treat symptoms that may actually be caused by other medications.
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