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Summary
On episode 604 of 40+ Fitness, Coach Allan sits down with Dr. Hedva Barenholtz Levy, founder of a community-based senior care pharmacy practice, a geriatric pharmacy specialist and educator who has published numerous peer-reviewed journal articles and book chapters on optimizing drug therapy in older adults.
They dig into her book, Maybe It’s Your Medications: How to Avoid Unnecessary Drug Therapy and Adverse Drug Reactions, starting with the idea that healthcare is a team sport and the patient is the most important player on that team.
The conversation covers the five characteristics that raise an older adult’s risk of an adverse drug event, the eight medication related problems she screens for in a full review, and how to approach deprescribing safely with a doctor or pharmacist.
Links
- https://maybeitsyourmeds.com
Key Takeaways
- Taking multiple medications raises your risk on its own. More chronic conditions mean more prescriptions, and every additional drug adds another chance for something to go wrong, which is why polypharmacy is the first of her five risk characteristics.
- Multiple prescribers can work against each other. The number of older adults seeing specialists has nearly doubled in 20 years, and if those doctors are not communicating, no one may know your full medication list or whether the drugs interact.
- Aging changes how your body handles drugs. Pharmacokinetics (how your body processes a drug) and pharmacodynamics (how a drug affects your body) both shift with age, so older adults often need lower doses or need to avoid certain drug classes altogether.
- Older adults are underrepresented in clinical trials. Trials mostly study people under 65 without multiple conditions, so a newly approved drug’s real-world safety and effectiveness in an older, more complex patient is often not fully known.
- A full medication review screens for eight distinct problems. Adverse reactions, drug interactions, doses too high or too low, the wrong drug choice, an undertreated condition, a medication never actually started, and unnecessary medications all get checked, not just whether you are “doing fine.”
- Lifestyle improvements can make an old dose too strong. Lower your blood pressure or blood sugar through diet and exercise and the dose prescribed years earlier may now push you too low, so tell your doctor when your habits change so they can adjust it.
- A yearly medication review catches what gets missed. A geriatric-trained pharmacist, nurse practitioner, or physician can look under the hood the way a mechanic would, and Medicare Part D includes a comprehensive review benefit worth asking your plan about.
- Deprescribing means slowly lowering a dose, not stopping cold turkey. Patients need to know in advance what symptoms to watch for in case the condition returns, which is why deprescribing should be a planned conversation, not a unilateral decision.
- Dr. Levy’s three strategies to get and stay well: adherence, taking medications exactly as prescribed rather than skipping doses on your own; minimizing unnecessary medications so side effects like drowsiness or fall risk do not undercut your quality of life; and self-advocacy, speaking up about how you feel day to day since you are the one constant link in your healthcare chain.
“The most important person on that team is you, the patient, the consumer, the one who’s taking those medications.”
Dr. Hedva Barenholtz Levy
Another Episode You May Enjoy
Episode 607 – 11 Vital Medical and Lab Tests After 40
Episode Notes
Podcast: 40+ Fitness
Episode: 604
Published: 2023-08-22
Host: Allan Misner (aka Coach Allan), author of The Wellness Roadmap
Guest(s): Dr. Hedva Barenholtz Levy, founder of a community-based senior care pharmacy practice, a geriatric pharmacy specialist and educator, Maybe It’s Your Medications
Listen & Subscribe: Apple Podcasts · Spotify · YouTube (audio only)