Is It Time to Review the Medications You Take?
- Many older adults take multiple prescription medications, over-the-counter medications, and dietary supplements. But not all medications provide benefit for the person taking them, and some may become unnecessary or even unsafe over time.
- “Deprescribing” is a collaborative process between patients and their healthcare providers to reduce or stop prescription medications, over-the-counter medications, and dietary supplements if a health care provider finds the drug the patient is taking is unnecessary and/or harmful.
While physicians caution patients to never stop taking medication without checking with a healthcare provider, some people, especially older adults, may not need all the medication they take.
A review of your medication can result in what researchers call “deprescribing.”
“The idea behind deprescribing is that some people are on drugs they don’t need, or should be on a different drug for a condition they are dealing with, or could benefit from a higher or lower dose of a drug,” Jeffrey Kullgren, MD, MPH, an associate professor of internal medicine at the University of Michigan Medical School, told Verywell.
Kullgren is behind the university’s National Poll on Healthy Aging, which surveyed over 2,500 people between the ages of 50 and 80 about deprescribing. Among the findings:
- 80% of people would be open to stopping one or more of the prescription medicines they’ve been taking for more than a year with the blessing of a healthcare provider—most notably, medication for heart disease prevention.
- 26% said they have stopped taking a long-term medication in the past two years.
- 36% of adults who stopped taking prescription medicine said they did so without talking with a health professional.
Reasons for stopping a medication range from resolution of symptoms and lack of perceived benefit to concerns about side effects and cost.
But experts think there’s something additional at play: Many older adults are just taking an unmanageable amount of prescriptions. After all, stopping a prescription medication was most common among those taking five or more medications.
How Much Is Too Much?
According to Susan Reinhard, PhD, RN, Senior Vice President at the AARP Public Policy Institute, adults ages 65 and older take 4.6 medications per month on average.
Once that figure creeps past five medications, the risk of negative interactions starts to increase. Research published in U.S. Pharmacist shows that people who take five to nine medications have a 50% chance of at least one drug interacting with another. Taking multiple drugs accounts for almost 30% of all hospital admissions in the U.S., and outcomes can be fatal.
“It’s important that patients not only have regular communication about the risks and benefits of each prescription with healthcare providers, but also with loved ones and family caregivers,” Reinhard told Verywell. “Research shows improved outcomes when family members help make decisions in the deprescribing process.”
Why Are Some People Taking Unnecessary Prescriptions?
Michael Steinman, MD, a professor of medicine at the University of California San Francisco School of Medicine, told Verywell that people may be taking a drug they no longer benefit from for a number of reasons:
- A physician may have prescribed a short-term drug, such as a medication to relieve heartburn, with no instructions on when to stop.
- Different providers write prescriptions without knowledge of other medications a patient is taking.
- A patient’s condition may have resolved, but nobody told them to discontinue their medication.
“A review of all the drugs you take—including over-the-counter products and supplements—can help your doctor determine the ones you need, the ones you don’t, best doses and also whether there are new and better drugs that might be good choices for you,” Steinman said.
And as you age, you may no longer benefit from a drug that was prescribed years earlier, said Emily Dornblaser, PharmD, associate professor and interim dean of the College of Pharmacy at the University of New England. Aspirin is a good example.
“For many years, we recommended people take baby aspirin to prevent first-time strokes and heart attacks,” Dornblaser told Verywell. “More recent data shows us that patients over the age of 60 on aspirin for [prevention of a first heart attack or stroke] have higher rates of gastrointestinal bleeding or other complications from the aspirin, and that the ‘protection’ they are getting is no longer worth the risk.”
Which Medications Are Typically for Short-term Use?
According to Dornblaser, many drugs should have a limited run for patients, including opioid prescriptions for acute pain, which are associated with substance use disorder. Additionally, long-term use of anti-anxiety medications like Ativan and Xanax is not recommended because they increase a person’s fall risk.
“Chronic pain has some different implications, and patients with chronic pain should work closely with their doctors or pain specialists to try to stay on the lowest amount of opioid possible,” she said.
Steinman adds over-the-counter heartburn drugs, as well as insomnia prescriptions, to the list. Taking heartburn drugs like Prilosec or Nexium can cause lung infections and urinary tract infections. Long-term risks of sleeping pills can include daytime drowsiness and sleepwalking.
What This Means For You
It’s a good idea to bring a list of all the medications—prescription and nonprescription—you take to the doctor for review at least once a year to learn if any of the drugs you take need to be changed or stopped. This could be a free appointment, even if done outside of your annual physical. Some insurers, including Medicare, cover the cost of a doctor’s visit intended for medication review.
Thanks for your feedback!
What is your feedback?