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A KFF Health News report describes the growing risks of taking multiple medications and encourages patients who are worried about side effects to discuss a medication review with their health care providers. The report cites research showing that the share of Americans over 65 taking five or more medications nearly doubled from 2000 to 2020; it does not advise patients to stop medicines on their own.
A KFF Health News report is urging people concerned about taking multiple medications to discuss a medication review, including whether any prescriptions can be safely tapered, with their doctors or pharmacists. The report connects the advice to rising polypharmacy among older adults and describes a patient whose medication interaction was associated with liver damage.
The report recounts the experience of Jonathan Bledsoe, a Marine veteran in Reading, Pennsylvania, who took medication to stabilize his mood and lower his cholesterol, along with other prescriptions. 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, the report said. After his medications were changed, his liver and kidney function returned to normal.
The report cites a study in JAMA Internal Medicine finding that the share of Americans over 65 who took at least five medications nearly doubled between 2000 and 2020. More than one-third of older adults now take five or more medications a day, according to the report. Amanda Mixon, a hospitalist and associate professor of bioinformatics at Vanderbilt University, said she sees older patients taking an average of 16 medications, often prescribed by multiple clinicians and filled at different pharmacies.
Medication risks can build through what clinicians call a prescribing cascade: a drug causes a side effect, another medication is prescribed to address it, and that combination may produce further problems. The report gives the example of a water pill used for heart failure that increases urination; resulting incontinence may then be treated with another drug. It recommends keeping an up-to-date list of prescriptions, over-the-counter medicines, vitamins and supplements, and bringing it to appointments.
Medication Reviews as Prescriptions Multiply
The report’s concern is not simply the number of medications a person takes. When prescriptions come from several clinicians or health systems, providers may not have a complete view of a patient’s medication list. That can make it harder to spot interactions and overlapping side effects, particularly as medication effects can change with age.
Deprescribing means intentionally reducing or stopping a medication when a clinician determines that it is no longer needed or that its risks outweigh its benefits. The aim, as pharmacist DeLon Canterbury describes it, is patient safety, not reducing medication counts for their own sake. A review can give patients and clinicians a chance to check whether each medicine remains appropriate and whether a symptom could be related to a drug.
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How Deprescribing Entered the Discussion
The report describes deprescribing as a practice that has gained momentum over the past decade, alongside increased attention to polypharmacy and medication-related harms. Canterbury, who leads the consulting company GeriatRx, said the evidence and methods for safely tapering medications are newer and are not yet widely taught in medical schools.
Some medicines require a planned reduction rather than an abrupt stop. The report advises people who are concerned—especially those experiencing a new symptom or unexpected side effect—to start a conversation with a primary care provider or specialist. It also reports that Centers for Medicare & Medicaid Services guidance issued this year clarified how physicians and pharmacists may be paid for medication reviews and help with tapering when appropriate. Previously, clinicians had reported uncertainty about payment for this time-intensive work.
“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 a Medication Review Can Establish
The report does not identify a single medication or combination responsible for the population-level increase in risk, nor does it say that taking five or more medicines is automatically unsafe. Individual risks depend on the medicines, the patient’s health and how drugs interact. Bledsoe’s experience is one reported case, not evidence that the same outcome will occur for other patients.
The source does not provide further detail on the CMS guidance, including its full implementation or how many clinicians have used the payment provisions. It also says safe tapering methods are not widely taught, but does not describe one tapering schedule that would apply across medicines. Patients should not treat the report as a direction to stop or change a prescription without clinical guidance.
Bring the List to Your Clinician
For people concerned about their prescriptions, the report’s practical next step is to write down all medicines and supplements, update the list when anything changes, and take it to a primary care appointment or specialist visit. Patients can describe new symptoms and ask whether any medication could be contributing, whether every prescription is still needed, and whether a change would require gradual tapering.
The report does not announce a new deadline or scheduled policy milestone. Further developments will depend on how clinicians and pharmacists use the CMS payment guidance and how medication reviews are incorporated into care. Any decision to reduce or stop a drug should be made with the prescriber or another qualified health professional who can account for the patient’s full medication list and health history.
Key Questions
What does polypharmacy mean in this report?
The report uses polypharmacy to describe taking five or more medications. It says the share of Americans over 65 taking that many nearly doubled from 2000 to 2020.
What is deprescribing?
Deprescribing is the intentional reduction or discontinuation of a medication when a clinician determines it is appropriate. Some drugs need to be tapered, so patients should discuss changes with a health professional rather than stop a prescription on their own.
What should I bring to a medication review?
Bring an up-to-date list of prescriptions, over-the-counter medicines, vitamins and supplements. The report says a paper list is a practical option if an app or other tracking method is not convenient.
Does taking five or more medications mean my treatment is unsafe?
No. The report does not say that a particular number of medications is automatically unsafe. It says multiple medicines can raise the chance of interactions and recommends discussing personal concerns and symptoms with a clinician.
Source: rss
