Managing Multiple Comorbidities More Easily

Over the past two years, the term “comorbidity” has been used more and more in public health conversations, thanks in large part to the COVID-19 pandemic. In the context of the pandemic, you’ve learned that people with comorbidities — or more than one pre-existing medical condition at the same time (such as diabetes and cancer) — are at greater risk for a negative outcome when infected with the virus that causes COVID-19. But Americans were managing multiple comorbidities long before March 2020. In fact, more than a quarter of U.S. adults have multiple chronic conditions, per the Centers for Disease Control and Prevention (CDC).¹

As you get older, you tend to develop more medical issues. In fact, some 60% of older adults have more than one chronic condition, per the National Institute on Aging.²

Now, let’s say you’re dealing with either multiple conditions or are at risk for developing more than one. Having multiple comorbidities can complicate your treatment plan³, and, in turn, this may make it more difficult for you to keep up with your doctor’s recommendations.

What can you do to better manage your multiple comorbidities? Below, find five helpful tips.

Tip #1: Manage your meds better

Your multiple comorbidities may require specific and different medications, so your clinician (or clinicians) may need to prescribe you multiple medications to manage your various symptoms. That in and of itself can be tough to manage. Recent data show that more than 40% of older adults take five or more prescription medications⁴ (you may see this referred to as polypharmacy⁵).

A good place to start with appropriately managing multiple comorbidities is proper medication management. This can be as easy as buying a new pillbox or using a medication scheduling app. You should also keep a detailed list of the medications, vitamins, and supplements you take so that you can review them with your doctor or pharmacist.⁶

Tip #2: Know what adverse drug events (ADEs) are and how you can avoid them.

The more prescription medications you take, the more likely that you could experience an adverse drug event (ADE), or a potentially harmful reaction to one or more medications.⁷

If you take prescription medications, an ADE could potentially be brought on by:

• A drug-drug interaction, “during which one drug affects how another drug is metabolized or how the drug acts on it’s target or receptor,”⁸ per Josh Peterson, M.D., a professor of biomedical informatics and medicine at Vanderbilt University’s School of Medicine and the director of the Center for Precision Medicine.
• A gene-drug interaction, in which your genetic makeup affects how your body metabolizes or responds to a medication or medications.^9,10

If you experience any reaction to your medications, contact your clinician. For severe reactions or if you are experiencing a life-threatening emergency, contact 911.

But there are ways you can help to avoid ADEs. Now that you have that comprehensive list of your medications, vitamins, and supplements from Tip #1 (see above), take an active role in presenting that list to your doctor or doctors. And don’t be afraid to ask your doctor or pharmacist about potential side effects or about how your medications may be interacting with each other.

Tip #3: Chronic conditions often compound one another — so beat them at their own game.

Sometimes “one condition can actually influence the other condition,” says Magali Haas, M.D. She’s the chair, CEO, and president of New York–based Cohen Veterans Bioscience, a nonprofit brain research organization dedicated to fast-tracking diagnostics and therapeutics to advance precision brain health.

Dr. Haas cites the connection linking depression and cardiovascular disease. “These are two conditions people don’t think of as being related to each other, but in fact we see these interactive effects are real and that improving one improves the other,” says Dr. Haas. “The converse is also true.”¹¹

She also points out that when patients feel positive about getting better, “it’s extraordinary to see how that actually has an influence on outcome. We’ve seen that again and again in medical practice.”

Tip #4: Don’t neglect exercise and nutrition.

Dr. Haas takes it a step further: “Consider exercise and nutrition. They both have positive effects on mental and physical health, and those effects are actually additive. So you have an outsized benefit from exercise because you treat your heart and your brain at the same time.”

• Exercise regularly. It not only can help prevent other health conditions from developing, but it can also boost your energy levels, improve your mood, and help you sleep better. (Of course, consult your doctor before starting any new exercise regimen.)¹²
• Eat a healthy, nutritious diet. This can be a valuable tool in chronic disease management for conditions such as type 2 diabetes and heart disease.¹³ (Also, it’s a good idea to consult your doctor before switching up your diet.)¹⁴

Tip #5: Ask your doctor if they offer precision medicine.

If you’re managing multiple comorbidities, precision medicine can be a game changer. It’s the practice of fine-tuning treatment, including medication, to suit the specific needs of an individual.¹⁵

Ask your healthcare provider if they’re familiar with companies like Genomind that offer precision medicine tools like pharmacogenetic (aka pharmacogenomic or PGx) testing. Pharmacogenetic testing provides insight into how your genes may affect your body’s response and/or tolerability to certain medications. This type of testing, in combination with software that can assess both drug-drug interactions and gene-drug interactions, can help your provider personalize your treatment plan. Both of these are offered by Genomind. Get started here.

“There’s a lot of promise there,” says Dr. Haas.

Tip #5: Practice patient advocacy for yourself.

“The No. 1 thing is you need to advocate for yourself,” emphasizes Dr. Haas. “You have to ask these questions: Will this medication have an interaction with this other medication I’m taking? Can we be more efficient in treating this combination of conditions that I have?”

Managing multiple comorbidities isn’t just about sitting back and having your doctors take responsibility for your care. You need to take an active role too — and it doesn’t have to involve a lot.

Going forward with multiple comorbidities

Bottom line: If you have multiple medical conditions, you’re not alone — and you now have multiple tips available to help you better manage them all.

Sources:

1. Stat on multiple chronic conditions: Prevalence of Multiple Chronic Conditions Among US Adults (2020)
2. Stat on multiple chronic conditions in older adults: Supporting Older Patients with Chronic Conditions (2017)
3. How having multiple comorbidities can complicate treatment: Importance of comorbidities in the treatment of primary care patients with heart failure—Baseline results of the observational RECODE-HF Study (2018)
4. Percentage of older adults taking more than 5 prescriptions: 5 Things to Know About Taking 5 or More Medications (2021)
5. Defining polypharmacy: Polypharmacy: Evaluating Risks and Deprescribing (2019)
6. Ways to manage multiple medications: Help for Managing Multiple Medications (2022)
7. Stat on ADEs: Adverse Drug Events in Adults (2017)
8. Drug-drug interactions: What Is a Drug Interaction? (2021)
9. Gene-drug interactions: Drug-drug-gene interactions and adverse drug reactions (2019)
10. More on gene-drug interactions: Drug–Gene Interactions: Inherent Variability In Drug Maintenance Dose Requirements (2014)
11. Link between depression and cardiovascular disease: Heart disease and depression: A two-way relationship (2017)
12. Benefits of exercise: Exercise: 7 benefits of regular physical activity (2021)
13. Diet and chronic disease: Eating for diabetes and heart health (2022)
14. Why to tell your doctor about diet changes: Should your doctor know what you eat? (2019)
15. Info on precision medicine: Precision or Personalized Medicine (2020)