As you take more prescription medications to manage illness, you drive up the potential risk for medication-related side effects: drug/drug, drug/food and drug/dietary supplement interactions. Polypharmacy, the routine consumption of five or more prescription medications with or without OTC medications and dietary supplements, is becoming more common.
Physician-directed polypharmacy de-escalation is a strategy to reduce the potential problems. As there are often several approaches to treating any health condition, physicians could try different techniques to reduce medication use.
De-escalation strategies incorporate patients' personal values regarding lifestyle changes and stress management. The doctor's goal is to move patients from more invasive to less invasive holistic strategies as much as possible, consolidating or eliminating medication regimens using one or more of the following techniques:
· Alternate medication schedules (every other day instead of daily)
· Therapeutic equivalents (combine evidence-based high-quality dietary supplements with prescription medications)
· Evidence-based dietary supplements instead of prescription medications (Glucosamine sulfate instead of Celebrex or other NSAIDs for arthritis pain management)
· Lifestyle or diet alone (for conditions related to stress, consider asking your physician about stress management techniques such as yoga, massage or acupuncture instead of antacids or prescription medications)
· Sleep hygiene (healthy sleep principles might be incorporated into conventional medicine by examining lifestyle choices that affect sleep and overall daily energy and refreshment as well as deeply rooted internal peace; you might need to ask your physician for a referral to a sleep specialist for more serious issues such as sleep apnea)
· Accentuate the positives (learn how to think positively about chronic illness, repeating affirming scripts like "My joints are strong and flexible" if you're suffering from arthritis; our emotions often go where our thoughts go).
· Evaluate your spiritual health (spirituality can play an important role in helping patients recover from illness).
There are also ways your can work with your physician:
· Conduct a comprehensive, integrative health assessment to determine what conditions/symptoms may be appropriate for medication or supplement de-escalation strategies.
· Talk about barriers to de-escalation.
· Journal about medication de-escalation strategies and learn what does and doesn't work.
· Develop health outcome goals and periodically reassess them.
· Recognize that you have the right to refuse a medication.
· Determine which integrative services are covered by third party insurance or Medicare; most are not.
Find the strategy that works best for you to reduce polypharmacy usage. Integrative health care practitioners can help patients focus on non-invasive holistic modalities for better health in the future. Don't forget to talk with your holistic clinical pharmacist about how best to purchase a quality dietary supplement to stay safe.
DR. CATHY CREGER ROSENBAUM is a Holistic Clinical Pharmacist and the founder and CEO of Rx Integrative Solutions, Inc. Find out more online at www.rxintegrativesolutions.com. Contact her at drcathy@rxintegrativesolutions.com.
