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A KFF Health News report describes rising use of multiple medications among older adults and the risks of interactions and side effects. Clinicians and pharmacists interviewed recommend keeping an up-to-date list and asking a health care provider whether any medicines can be safely reduced or stopped. Deprescribing should be planned with a clinician, not done independently.
A KFF Health News report says the growing number of older adults taking several medications is increasing concern about drug interactions and side effects, and urges patients with concerns to review their regimens with a clinician. The report recommends keeping a current list of prescriptions, vitamins and supplements and asking whether any medication can be safely reduced or stopped rather than making changes alone.
The report describes Jonathan Bledsoe, a Marine veteran from Reading, Pennsylvania, who took medication for mood stabilization and cholesterol, among other drugs. After he noticed that his urine had turned dark, he raised the symptom with his doctors. He learned, according to the report, that an interaction between his medications was beginning to damage his liver. After his medications were changed, his liver and kidney function returned to normal.
A study published in JAMA Internal Medicine found that the share of Americans over 65 taking five or more medications nearly doubled between 2000 and 2020; the report says more than one-third of older adults now take that many daily. 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 multiple pharmacies.
The report explains that a prescribing cascade can occur when a drug causes a side effect that is treated with another medication, potentially adding further side effects and prescriptions. DeLon Canterbury, a pharmacist and chief executive of GeriatRx, said patients should not assume one professional is checking every medication across separate health systems. Pharmacist Jen Hammons, a rural health advancement director at the Appalachian College of Pharmacy, recommends carrying a written list if a digital option is not practical.
Why Multiple Prescriptions Raise Risks
Taking several medications does not automatically mean a person is overmedicated: each drug may have a valid purpose. But as the number of medicines grows, the chance of interactions and cumulative side effects can rise, according to Mixon. The effects can be harder to recognize when prescriptions come from different clinicians who may not share the same records.
The report says older adults can process medications differently as they age, potentially increasing the likelihood of adverse effects such as constipation, diarrhea, falls and memory problems. A review can help identify whether a symptom might be medication-related, whether two medicines conflict, or whether a treatment remains appropriate. The aim of deprescribing is safety, Canterbury said, not removing as many drugs as possible.
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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 no longer needed or its risks outweigh its benefits. The report says the practice has gained momentum over the past decade as polypharmacy and concern about its effects have grown. Canterbury said the evidence and methods for tapering safely are newer and are not yet widely taught in medical schools.
The report also notes that the Centers for Medicare & Medicaid Services issued guidance this year clarifying how physicians and pharmacists can be paid for medication reviews and help with tapering when appropriate. Previously, the report says, some physicians were uncertain about payment for deprescribing work, which can take time. It also describes political debate over psychiatric medications, including Health and Human Services Secretary Robert F. Kennedy Jr.’s calls to reduce their use, a position that has divided the medical community. The report does not present that debate as evidence that any particular patient should stop treatment.
““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
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What a Medication Review Can Establish
The report does not say how many people taking multiple medications experience harmful interactions, or identify a single number of prescriptions that is unsafe for everyone. Individual risks depend on the drugs, health conditions and patient circumstances; the study statistic describes medication use, not the rate of injury. It is also unclear how widely the newer CMS payment guidance will change access to medication reviews in practice.
The report gives one patient’s experience but does not establish that every new symptom is caused by medication. Nor does it recommend stopping any specific drug. Tapering can require a plan, and the report notes that safe tapering practices are still developing. Patients should not change or discontinue prescribed treatment without speaking with the clinician responsible for their care.
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Bring the Full List to Your Clinician
For patients concerned about side effects, a practical next step described in the report is to make a complete, current list of prescriptions and nonprescription products, including vitamins and supplements. Bring it to a primary care provider or relevant specialist, mention any new or unexpected symptoms, and ask whether the medicines remain necessary and whether any interactions or safer alternatives should be reviewed.
If a clinician recommends reducing a medication, the patient and provider can discuss how to do so and what symptoms or changes to monitor. The report does not announce a new clinical deadline or policy implementation date; the next step for an individual depends on a discussion with their care team.
pill organizer with medication list
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Key Questions
What does deprescribing mean?
Deprescribing is a planned process of reducing or stopping a medicine when a patient and clinician decide it may no longer be needed or its risks may outweigh its benefits. It is not a recommendation to stop treatment without medical guidance.
Does taking five or more medications mean someone is overmedicated?
No. The report uses five or more medications as a definition of polypharmacy in the cited study, not as a universal threshold for unsafe treatment. Whether a regimen is appropriate depends on the person’s health and the medicines involved.
What should I include on a medication list?
List prescription drugs, over-the-counter medicines, vitamins and supplements, and keep the information current. The report recommends carrying the list to appointments so clinicians can review the full combination.
Should I stop a medication if I suspect a side effect?
Do not stop or taper a prescribed medication on your own. Contact your prescribing clinician or another qualified health professional to discuss the symptom and determine whether a change is appropriate.
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