Dr Susan Connelly: Starting and changing medicines
Listen to patients and health professionals speak about their experience with taking multiple medicines.
Dr Susan Connelly
Main occupation: Geriatrician (specialist in aged care)
Years in clinical practice: 20
Qualifications: MBBS, FRACP
Dr Susan Connelly, geriatrician, describes how the considerations regarding medicines for older patients can be very different from those for younger patients. Medication may need to change with increasing age.
I guess, every now and then, say, ‘Look, do I still need to be taking this? I've lost some weight. Do you think I could be tried off my antihypertensive?’ Again, likewise, they've given up alcohol, because we know alcohol is a big contributor to hypertension, for example. If they've given up the booze, maybe they don't need to be on their antihypertensive.
I get very case specific, I guess, but does it interact, do I still need to take all these tablets and, again, this is more relevant for the population I deal with ... when people are getting older and we are looking at more end-of-life ... not so much end-of-life care, but quality of life in those latter years ... how many of these are really necessary? What am I trying to prevent? What am I trying to do here with these medications? Do we really need to be on a lot or all of these preventive measures, which we know apply to 50-year-olds, but do they apply to 85-year-olds? ... at which point, ‘OK, they've done their job. Do we really need to keep taking them?’ They're just sort of questions that are there.
I guess we just need to think twice, because I see people very much in the latter years of their life and often people that are moving into residential care. I really have a serious look at medications. I will leave people on their diuretics, if I know that it's treating their heart failure, because you don't want someone to be breathless and uncomfortable. But I might stop their Aricept because they're now so confused and so disoriented that they don't really need to be on their Alzheimer's medication anymore and it's not particularly efficacious anyway.
Again, it's a case-dependent thing and you have to discuss it with, maybe in this situation, perhaps the family, but again, things change. People's lives are dynamic ... where we are at in our lives ... you just have to judge the situation as well.
The Living with multiple medicines project was developed in
collaboration with Healthtalk Australia.