TL;DR
More than one-third of older adults in the United States take five or more medications a day, and a study found the share nearly doubled from 2000 to 2020. Experts cited by KFF Health News recommend keeping an up-to-date medication list and discussing potential side effects or deprescribing with a clinician; patients should not stop medicines on their own.
More than one-third of older adults in the United States take five or more medications a day, as the share of people over 65 taking that many nearly doubled from 2000 to 2020, according to research cited in a KFF Health News report. The report urges people worried about side effects or medication combinations to review their prescriptions with a health professional and ask whether any medicines can be safely reduced.
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The report describes polypharmacy as taking five or more medications and says the risks can grow when prescriptions come from different clinicians or pharmacies. 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. She said additional medicines can interact and produce side effects, which may lead to still more prescriptions.
Jonathan Bledsoe, a Marine veteran from Reading, Pennsylvania, told the news service that after nearly three years on several medications, he noticed his urine had become dark. He said doctors found an interaction between his medicines was beginning to damage his liver. After he changed medications, he said, his liver and kidney function returned to normal. His experience is a reported case, not evidence that every medication combination will cause harm.
The report also describes a prescribing cascade: a medicine causes a side effect, another medicine is prescribed to address it, and the combination may create further problems. Pharmacist DeLon Canterbury said clinicians may not have access to a complete medication record when a patient sees providers in different health systems. Experts interviewed recommend maintaining a current list of prescriptions, vitamins and supplements and bringing it to appointments.
Why Multiple Prescriptions Need Review
Taking several medicines can be appropriate, and the report does not suggest that patients should stop useful treatment simply to reduce their medication count. The concern is that each additional drug can make it harder to spot interactions, overlapping effects or side effects, particularly when several prescribers are involved. A medication review can help clinicians consider whether a symptom is related to a drug and whether a treatment remains needed.
The report says bodies may process medicines differently with age, which can affect the likelihood of adverse effects such as falls, constipation, diarrhea or memory problems. These risks matter to patients and caregivers because medication changes can require careful monitoring. Any decision to taper or discontinue a drug should be made with a qualified clinician; the report does not advise patients to stop medicines independently.
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How Deprescribing Entered the Discussion
Deprescribing means intentionally reducing or stopping a medication when a clinician and patient determine it is appropriate. The KFF Health News report says the practice has gained momentum over the past decade alongside concern about polypharmacy. Canterbury said the science on safe tapering is newer and that deprescribing is not yet widely taught in medical schools.
The report also notes 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 tapering work when appropriate. Previously, some physicians were uncertain about payment for the time such reviews can require. 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 political debate is distinct from an individual medication review.
“As you accumulate more and more medications, the chance of them interacting with each other and having bad interactions increases.”
— Amanda Mixon, hospitalist and associate professor of bioinformatics at Vanderbilt University
What Medication Reviews Can Establish
The report does not identify the medications involved in Bledsoe’s interaction or provide details of his diagnosis and treatment, so readers cannot use his case to assess their own prescriptions. It also does not establish how often medication interactions cause harm across the population. The cited study documents a rise in the number of older adults taking five or more medications, but that measure alone does not show that every person taking several medicines faces the same level of risk.
It remains unclear how widely clinicians will use the CMS payment guidance or how much it will change access to medication reviews. The report also gives no single tapering schedule: the right approach depends on the drug and the patient. A clinician should assess whether a medication is appropriate and how any change should be monitored.
Bring a List to Your Next Visit
For someone concerned about a new symptom, side effect or a long medication list, the report’s practical next step is to write down every prescription, vitamin and supplement and share the list with a primary care provider or relevant specialist. Patients can ask whether medicines may interact, whether a symptom could be a side effect, and whether any prescription can be reviewed or tapered safely.
Clinicians and pharmacists would need to guide any change and monitor the patient as needed. The report does not announce a new national program or a timetable for further action; it describes CMS guidance already released this year and ongoing efforts to make medication reviews part of care. The effect of that guidance on patient access and prescribing practices has not yet been established in the report.
Key Questions
What does polypharmacy mean in this report?
Polypharmacy refers here to taking five or more medications. The report says more than one-third of older adults take at least that many each day.
What is deprescribing?
Deprescribing is the intentional, clinician-guided process of reducing or stopping a medication when it is appropriate for the patient. It is not a recommendation to discontinue medicines without medical guidance.
Should I stop a medicine if I suspect a side effect?
The report advises discussing concerns with a qualified health professional, not stopping a medication independently. A clinician can review the medication and determine whether a change or monitored taper is appropriate.
What should I bring to a medication review?
Bring an up-to-date list of prescriptions, vitamins and supplements, including medicines prescribed by different clinicians. The report says a paper list can work as well as an app.
What did CMS change?
The report says the Centers for Medicare & Medicaid Services released guidance this year clarifying how physicians and pharmacists can be paid for reviewing medications and helping patients taper them when appropriate. Its effect on access to reviews is not yet clear.
Source: rss
