Open almost any medicine cabinet today, and you will likely find a long list of pills. Some for blood pressure. Some for cholesterol. Others for sleep, pain or anxiety. Many were prescribed years ago and never revisited.

In this episode of Hadassah On Call: New Frontiers in Medicine, we take a closer look at polypharmacy, the underrecognized risk of taking too many medications, especially as we age.

Host Maayan Hoffman sat down with Dr. Yosef Caraco, director of clinical pharmacology at Hadassah Hospital Ein Kerem, to explore what polypharmacy really means and why the issue is more complicated than it sounds.

“Scientifically, it means that the patient is getting more than five medications,” Dr. Caraco explains, noting that the average older patient today is taking closer to eight.

But the real problem, he says, is not the number of pills. It is whether each one still has a purpose.

“The right terminology should be optimized therapy,” Dr. Caraco says. “If you have a disease that needs to be treated, it is important to get the treatment. But if you’re taking medication for no reason, that’s not wise.”

We talk about drug evaluations, why different specialists often prescribe drugs without communicating with one another and how side effects can spiral into what Dr. Caraco calls a “cascade of prescriptions,” where one drug leads to another and another.

The episode also explores warning signs of overmedication, the limits of over-the-counter supplements and why patients should never stop medications on their own.

“Every physician should use the concept of risk-benefit,” Dr. Caraco says. “You should exercise it every day.”

We also discuss the role of lifestyle changes, the role of clinical pharmacists and why better conversations between doctors and patients can literally save lives.

Further Learning:

• Be sure to check out our previous podcast, Secrets to Living Better While Growing Older, with Dr. Jeremy Jacobs, chair of the Geriatric and Rehabilitation Complex at the Hadassah Medical Organization
• Older People Who Get Out Live Longer
• ICU Docs Coin Term for Elderly’s Multiple Ailments and Urge New Approach
• Hadassah Geriatrician: Don't Generalize About Old People and COVID-19

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Hadassah On Call: New Frontiers in Medicine is a production of Hadassah, The Women's Zionist Organization of America. Hadassah enhances the health of people around the world through medical education, care and research innovations at the Hadassah Medical Organization. For more information on the latest advances in medicine, please head over to hadassah.org.

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