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A KFF Health News report describes rising use of multiple medications among older adults and the risks that can come from drug interactions or prescribing cascades. Experts advise patients who have concerns to bring an up-to-date list of prescriptions, vitamins and supplements to a clinician and ask whether any medicines remain necessary; patients should not stop drugs on their own.
A KFF Health News report describes the rising use of multiple medications among older adults and urges patients concerned about side effects or drug interactions to discuss their treatment with a clinician. The report cites a study finding that the share of Americans over 65 taking five or more medications nearly doubled from 2000 to 2020, and says more than a third of older adults now take that many each day.
The report recounts the experience of Jonathan Bledsoe, a Reading, Pennsylvania, Marine veteran who took several medicines, including prescriptions for mood stabilization and cholesterol. After he noticed that his urine had turned dark, he raised the symptom with his doctors. They found that an interaction between his medications was beginning to damage his liver, according to the report. After he changed medications, his liver and kidney function returned to normal.
Amanda Mixon, a hospitalist and associate professor of bioinformatics at Vanderbilt University, told KFF Health News that she sees older patients taking an average of 16 medications, often prescribed by multiple clinicians and filled at different pharmacies. She said a growing medication list can increase the chance of interactions and side effects. The report also describes a “prescribing cascade,” in which a side effect from one drug is treated with another medicine, potentially adding further complications.
Experts quoted in the report recommend maintaining a current list of prescriptions, vitamins and supplements and bringing it to medical appointments. Patients with concerns, including new symptoms or unexpected side effects, can ask a primary care clinician or specialist to review their medicines and discuss whether any can be reduced or stopped safely. Deprescribing means intentionally tapering medication when appropriate; it is not a recommendation to stop treatment without medical guidance.
Why Medication Reviews Matter
When different clinicians prescribe medicines, they may not share the same records or know everything a patient takes. That can make it harder to spot interactions or understand whether a new symptom is related to a medication. The report quotes pharmacist DeLon Canterbury, who said patients should not assume another professional is checking every medicine in the background.
Reviewing treatment can help clinicians weigh a medication’s intended benefit against side effects, interactions and changes in how a person’s body processes drugs with age. The goal, Canterbury said, is patient safety, not reducing the number of medicines for its own sake. A conversation can also help patients understand what a medication is for and what monitoring may be needed.
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How Deprescribing Entered Care
The report says interest in deprescribing—planned, clinician-guided reduction or discontinuation of medication—has grown over the past decade as polypharmacy and related concerns have gained attention. Canterbury said the science on how to taper medicines safely is newer and is not yet widely taught in medical schools.
The report also points to a policy development: the Centers for Medicare & Medicaid Services released guidance this year clarifying how physicians and pharmacists can be paid for medication reviews and help with tapering when appropriate. Previously, some physicians were uncertain whether this time-intensive work could be reimbursed. Separately, Health and Human Services Secretary Robert F. Kennedy Jr. has advocated reducing psychiatric medication use, a position the report says has polarized the medical community. That policy debate is distinct from an individual patient’s clinical decisions.
““As you accumulate more and more medications, the chance of them interacting with each other and having bad interactions increases.””
— Amanda Mixon, Vanderbilt University hospitalist and associate professor of bioinformatics
Questions Before Changing Treatment
The report does not identify a single medication count that is unsafe for every person. Risk depends on the specific drugs, doses, health conditions and combinations involved. Nor does it establish that all older adults taking five or more medicines experience harm; the cited statistic measures medication use, not adverse outcomes.
It is also unclear from the report how widely the new federal payment guidance will change access to medication reviews or how many patients will receive deprescribing support. The account of Bledsoe’s recovery is one patient’s experience and does not establish that medication changes will produce the same result for others. Any decision to taper or discontinue a drug requires individual clinical advice.
Bring a List to Your Clinician
People concerned about a medicine or a new symptom can take a written or digital list of all prescriptions, over-the-counter drugs, vitamins and supplements to a primary care clinician or specialist. They can ask what each medicine is intended to do, whether any may interact, and whether a supervised dose change or taper is appropriate. Patients should not stop or change a prescribed medicine on their own, since some drugs require a gradual reduction or other monitoring.
Clinicians and pharmacists can review the list and coordinate with other prescribers where needed. The next steps for broader access to paid reviews will depend on how health systems and providers apply the CMS guidance; the report does not give an implementation timeline.
Key Questions
What does polypharmacy mean in this report?
It refers to taking five or more medications. The report cites a study saying the share of Americans over 65 taking that many nearly doubled between 2000 and 2020.
What is deprescribing?
Deprescribing is the planned reduction or discontinuation of a medication when a clinician determines it may be appropriate. It can involve tapering and monitoring, rather than stopping a drug abruptly.
Should I stop a medication if I suspect a side effect?
No. Contact the prescribing clinician or another qualified health professional to discuss the symptom and treatment. Some medicines can cause problems if stopped suddenly, so changes should be guided by a clinician.
What should I include on a medication list?
List prescription and over-the-counter medicines, along with vitamins and supplements. Keep the information current and bring it to appointments or pharmacy visits.
Source: rss
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