People take so-called “maintenance drugs” to reduce the risk or progression of some diseases and conditions. For example, a patient will take certain medications to decrease their risk of a heart attack or stroke. Patients may take a medication or a combination of medicines for years or even a lifetime. But there are some circumstances in which your doctor may choose to change or discontinue your regimen — even when it seems to be working well for you.
“It comes down weighing the benefits and the risks” said Jay Rajda, M.D., MBA, FACP, Aetna’s chief clinical transformation officer. “Has the balance changed? If it has, it’s time to rethink the treatment strategy.”
Many maintenance drugs have to be taken for years before the full benefit kicks in, Rajda said. As a patient ages, it sometimes makes sense to reconsider whether the patient would truly benefit from continuing to take certain medications.
At the same time, the risk of side effects from medications increases with age. As we get older, the ability of our bodies to absorb, store, metabolize and eliminate drugs from our system changes. This might necessitate a re-evaluation of which medications continue to be most beneficial and in what doses.
Getting the right mix of drugs
As we get older, many people are on several maintenance drugs, Rajda said. Because of this, doctors have to look at how all of your drugs are working together. It’s possible for two drugs to not interact well. You may take different drugs together for years, then start to have problems. When this happens, a doctor has to make a decision, Rajda said.
“With geriatrics, polypharmacy is a big deal,” he said. “Geriatricians often need to be very pro-active about reevaluating medication and treatment plans.
“When changes to medications become necessary, and are recommended by the doctor, patients shouldn’t be concerned” Rajda said. “It’s usually done because the patient is not likely to benefit from the treatment like they used to, or because the risk of harm outweighs the potential for benefit. It may not be favorable for the patient to continue taking certain medications.”
Do not stop a drug without talking with your doctor
It’s important, Rajda said, for doctors to be aware of all medications and over-the-counter drugs their patients may be taking. Rajda recommends talking to your doctor each time you see them about all the drugs you’re taking.
“If you’re getting medication from various doctors, it’s very important to discuss with your primary treating physician what treatment you’re on, including over-the-counter drugs.”
Your doctor will make recommendations on treatment plans, if necessary.