Pushing Back on a "Pill for every Ill"

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What happens when a patient decides they don't want to take all these pills anymore? How can help them reduce the need for taking so many medications?

by Kristi Van Winkle Kristi Van Winkle, BSN, RN

Specializes in Pediatrics/Telemetry/Health and Wellness. Has 18 years experience.

How can Nurses help reduce medication overload?

Pushing Back on a "Pill for every Ill"

Polypharmacy has swept the country. More than 40 percent of older Americans regularly take five or more prescription drugs, and nearly 20 percent take 10 or more. In addition to side effects, many medicines disrupt key nutrients in the body. There’s also the potential of drug-drug interactions.

On top of this, there’s increasing reluctance coming from patients, who would like to be taking fewer, not more medications. How often have you heard:

You're not adding ANOTHER pill, are you?

I take so many medications now, it's ridiculous!

That's it! I'm not taking any more medication! In fact, I'm going to stop taking the ones I'm already on now! Get rid of this garbage!

As a matter of fact, I had a patient make this last statement to me.  He did so as he slammed his pills down on his bedside table and they all popped out of the cup and clattered onto the floor. Luckily, I was able to talk him into continuing to take his medicine until he could talk to his doctor and figure out a better plan.

Many patients are not compliant with their medications. With so many onboard, they struggle trying to remember what to take when: before, during or after meals? On an empty stomach? Before bed or first thing in the morning?

It can get frustrating! How can we help our patients who don't want to take “a pill for every ill?”

Here are a few non-pill things we can suggest to our patients, with a doctor's approval, of course.

Diet Modifications

You are what you eat.

This is one we all know about, but sometimes it's just easier to give a pill than to try to convince someone to eat differently.

Sometimes a diet change can keep a patient from needing medication for a few more years, or maybe indefinitely.

Of course, you should always remind the patient to not discontinue a medication without first speaking with their doctor. They should also discuss any diet changes with their doctor. Some diet changes, and even losing weight can affect medication dosage. Diet modification is usually a positive option to reduce the need to take more pills.

Exercise

Most medical conditions can be improved by a bit of exercise.

Encouraging our patients to find exercises that work for them and their particular situation, and then encouraging them to stick with it, will help them maintain their health and perhaps delay the need to add a new medication.

Even adding something as simple as stretching, taking more steps each day, or gently jumping on a mini trampoline for 15 minutes a day can make a big difference in someone's life.

Neurostimulation

This one was new to me up until about a month ago. I want to try it for myself!

gammaCore has developed a small, hand-held neurostimulator that is FDA cleared to treat migraines and cluster headaches. This thing is small enough to fit into your pocket, purse, or backpack and can be used in conjunction with other medications, with no side effects.

In the United States, it is only FDA cleared for headaches at this time, but ongoing studies are being done for use in:

  • Post-traumatic stress disorder
  • Parkinson's disease
  • Gastroparesis
  • Post-op ileus
  • Opioid use disorder
  • Acute stroke
  • Subarachnoid hemorrhage
  • Traumatic brain injury 
  • ... and probably other things

You do need a medical provider's order, but they can approve it right on the site.

Check it out for your headache patients now, and keep an eye on it for future approvals. It might be just the thing you or your patient needs.

Vitamins, Supplements, Herbs

My mom swears by red yeast rice. She tells me her doctor has been threatening to put her on a hyperlipidemia medication for several years now, and she has been able to keep her levels where her doctor wants them using red yeast rice.

Supplements, vitamins, and herbs may be just the thing to stave off one more pill for your patient. Just be sure to remind your patient to talk to their doctor and do their own research before adding any of these things to their diet. While many drugs are known to disrupt nutrient absorption and metabolism, there are a few supplements that can interfere with medications. You can look up drug-nutrient interactions on mytavin.com.

Summary

I think we would all agree that adding one more medication is not always the answer. Not for us, our families, or our patients. Navigating the sea of pharmaceuticals and balancing their use with lifestyle, nutrition, and intelligent supplementation can be tricky, to say the least, but it is very worth it to help patients reach higher levels of well-being.

Helping our patients find the best solutions to their health challenges can be, well, challenging, but knowing that we made a difference in someone's life simply by providing options can be very rewarding.


References/Resources

Medication overload and older Americans

gammaCore

I am an RN turned freelance medical writer and editor/proofreader. I especially enjoy and excel at writing articles that provide education for patients and their families.

4 Articles   16 Posts

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1 Comment(s)

Louise Mooney, RN

Specializes in Holistic Nurse Coach and Freelance Writer. Has 33 years experience. 1 Post

Thank you for sharing this interesting article Kristi. How much better would it be if our patients could reduce their medication intake by improving their overall lifestyle? Exercise and improved nutrition can't be overestimated!