Elderly patients often take multiple medications for multiple diseases and/or future risk factors. The issue with taking more medications is that they can have negative interactions with each other. Overmedication is a huge issue, especially with the elderly and this effect can be magnified by a simple fact: that individuals can metabolize medications differently based on genetics. If medication circulates too long in the bloodstream, the same compounds that make life easier can make it much worse in a few ways. Using pharmacogenetic (PGx) testing, you can utilize the newest technology to ensure your patients are properly medicated and at the correct dosages to prevent further problems down the line.
The most obvious solution that PGx provides is the ability to prescribe the proper amount of medication to your patients. Most drugs are initially metabolized by the cytochrome P-450 enzyme and the rate that drugs are metabolized in patients decreases with age, a factor usually taken into account. However, the base metabolic rate varies from person to person, as the enzyme is slightly different based on the genetics of the individual (Pharmacokinetics in Older Adults). A simple PGx test allows proper dosage for each patient, ensuring no one overdoses on an otherwise normal amount of medications.
A prescribing cascade is another relevant issue that can easily stem from overmedication due to improper dosage (Ponte, 2017). If too much medication is circulating in the bloodstream, the chance of normal and rare side effects is increased. However, as the name suggests, when patients experience more issues, especially elderly patients often already taking a few or more medications at once, it is nearly impossible to differentiate between a side effect or comorbidity. This can cause an increase in medication, also increasing the likelihood of negative interactions and more side effects, especially since metabolism still won’t be taken into account.
Elderly patients are at also much higher risk for falls. According to the CDC, there are 3 million falls annually and of those, around 40-50% could be prevented (Zaninotto, 2020). There are many medications that exacerbate the risk of falls with side effects like dizziness, however, these are often avoided in older patients, if possible. Polypharmacy is another big
risk factor, with a much larger increase in fall risk compared to patients who take fewer medications. If medicine is lingering in a patient’s bloodstream for longer than intended, or a prescription cascade is an issue, patients are at much higher risk for falls. Unfortunately, falls often decrease elderly patients’ individuality and cause the need for even more medicine.
This cycle of prescription is usually a downward spiral that leads to more negative effects. Medicine is intended to increase quality of life, yet if improperly utilized, has the ability to cause almost more issues than it fixes. A simple genetic test will allow you to decrease side effects, diagnose new problems more easily and reduce fall risk stemming from overmedication. Contact us today to learn how you can use genetic testing to start caring for your patients more effectively.