The American Geriatrics Society recently published a list of the “Five Things Physicians and Patients Should Question”. These are useful tips to consider when you or a loved one is being prescribed medications. This list includes:
1) Prescribing cholinesterase inhibitors for dementia without period assessment for perceived cognitive benefits and adverse gastrointestinal effects. (Cholinesterase inhibitors include the following medications: Aricept, Donepezil, Razadyne, Galantamine, Exelon, Rivastigmine). If you or a loved one is prescribed a cholinesterase inhibitor, the following source will give you more information regarding how this medication works and the possible side effects: http://www.dementiaguide.com/aboutdementia/treatments/cholinesterase_inhibitors/)
2) Recommending the screening for breast cancer or colorectal cancer, nor prostate cancer (with PSA test) without considering life expectancy and risk of testing, over diagnosis and overtreatment.
3) The prescribing of prescription appetite stimulants or high-calorie supplements for treatment of anorexia or cachexia in older adults; instead optimize social supports, provide feeding assistance and clarify patient goals and expectations.
4) Prescribing a medication without conducting a drug regiment review first.
5) Use of physical restrains to manage behavioral symptoms of hospitalized older adults with the delirium.
If any of the above tips apply to you and you feel your doctor is not addressing it, it is advised that you open up a conversation with the physician. It is also helpful to bring a list of medications to doctor’s appointments to discuss any possible side effects or confliction of medications.
Along with this list is a brief explanation for each of these suggestions. This can be found at http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/choosing_wisely2014. This is the second list published by the American Geriatric Society. The first list can be viewed at http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelin