They always tell you to listen to your doctor and take your pills regularly. What I want to tell you is: make sure your doctor listens to you and regularly reviews the absolute need for every single pill you take.
I have a name for the pills you don’t really need: “junk meds”. Unfortunately, there seems to be a 50/50 rule for junk meds. More than 50% of the patients I see are on junk meds. More than 50% of the pills of those patients are junk meds.
I admit that I may be somewhat biased about junk meds. As a hospitalist, I only see patients that are admitted to the hospital. It is my job to review all the medications and decide which ones they really need during their hospital stay. When I see the patients, they are usually in pain and distress. I meet them when they are very anxious, scared and vulnerable. I can see how the sheer number of pills they have to take adds to their stress and anxiety.
What does the profile of patients with more than 50% junk meds look like? Here are the 6 signs of a medication profile with junk meds:
1. More than 3 different vitamins and more than 2 different supplements:
Some patients need vitamins and supplements because certain diseases or certain medications can deplete nutrition form the body. Except in such cases, having more than 3 different vitamins and more than 2 different supplements is a tell-tale sign of a junk med profile.
2. Medications for diarrhea and constipation at the same time:
This seems like a common sense but you would be surprised to see how many patients are taking medications that cause diarrhea and are treating it with medications that slow the diarrhea down. This happens more frequently in nursing home patients. To avoid constipation, many doctors routinely prescribe stool softeners and laxatives to elderly patients in nursing homes. Some of them develop diarrhea. Instead of taking them off the laxatives, they add medications to slow the diarrhea down. “If you have constipation take this, if you have diarrhea take that” is a perfect example of why patients end up getting junk meds.
3. Heartburn medications without a history of heartburn:
Many doctors routinely prescribe medication to suppress stomach acid production in patients who are under severe medical stress. It is reasonable to do so when patients are admitted to the hospital for a serious life-threatening diagnosis. When doctors forget to discontinue these medications after patients recover from the illness, they become a part of the medication profile and remain there as junk meds.
4. Anxiety and depression meds without a formal diagnosis of anxiety and depression:
In the last seven years of my medical career as a hospitalist, I have seen that almost every patient with multiple chronic medical problem is on at least one anti-depressant or anti-anxiety pill. Almost half of those patients have not been formally diagnosed with clinical depression or anxiety disorder. They simply believe the doctor prescribed these pills to “calm their nerves”. They were given those pills when they felt overwhelmed by their medical diagnoses. Anxiety and depression pills when used as replacement for reassurance and education are definitely junk meds.
5. Seasonal allergy medication for all seasons:
It is reasonable to use daily medication to prevent allergies in susceptible patients during peak allergy season. Unfortunately, these allergy medications remain on the list of many patients all year long.
6. Too many herbal medicines:
Not all herbal medications are junk meds. I am not against alternative therapies. Herbs and alternate therapies may have a role in treatment of some chronic problems. However, when you see a patient taking 5 different herbs on top of ten prescription meds, you know there is a problem. Herbs contain naturally occurring compounds that have pharmaceutical properties. Naturally occurring does not mean that those chemicals behave any differently than manufactured chemicals of the same class. Herbs do interact and interfere with other medications and can cause serious complications.