TL;DR
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A KFF Health News report describes rising use of multiple medications among older adults and the risks of drug interactions and side effects. Clinicians say patients can ask their doctors or pharmacists to review prescriptions, but should not stop or taper medication without professional guidance.
A KFF Health News report is urging people concerned about taking multiple medications to discuss a review with their doctors or pharmacists, amid evidence that more than a third of adults over 65 take five or more medications daily. The report describes potential drug interactions and side effects, while stressing that deprescribing means a planned reduction when appropriate—not stopping medicines independently.
The report recounts the experience of Jonathan Bledsoe, a Reading, Pennsylvania, resident who took medication for mood stabilization and cholesterol, among other prescriptions. After he noticed that his urine had turned dark, he raised the symptom with his doctors and learned that an interaction between his medications was beginning to damage his liver, according to the report. After his medications were changed, his liver and kidney function returned to normal.
Older adults’ use of multiple medications has increased. 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. Vanderbilt University hospitalist and associate professor Amanda Mixon said she sees older patients taking an average of 16 medications, often prescribed by multiple clinicians and filled at different pharmacies.
One concern is a “prescribing cascade,” in which a side effect from one drug is treated with another medication, potentially adding further side effects or interactions. The report advises keeping an up-to-date list of prescriptions, vitamins and supplements, and bringing it to appointments. It also recommends raising concerns about a new symptom or unexpected side effect with a primary care provider or specialist.
Why Medication Reviews Matter
When several clinicians prescribe medicines, no single provider may have a complete picture of what a patient takes, particularly when care is split across health systems with separate records. Pharmacist DeLon Canterbury cautioned that patients should not assume someone is checking every medication combination in the background. That gap can make an accurate medication list and direct questions practical tools for safer care.
Medication risks can also change with age. Canterbury said older bodies process medications differently, which can raise the likelihood of side effects including falls, constipation, diarrhea and memory loss. A review can help clinicians consider whether each medicine remains appropriate, whether doses or combinations need attention, and whether a side effect could be connected to treatment. The report does not argue that patients should reduce medication counts as an end in itself: the stated goal is patient safety.
Deprescribing can take time because some medicines need to be tapered rather than stopped suddenly. Canterbury said the evidence and clinical training on safe tapering are still developing and are not widely taught in medical schools. Patients should therefore work with a qualified clinician on any change, rather than altering a dose on their own.
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How Deprescribing Entered the Discussion
Deprescribing is the intentional, clinician-guided reduction or discontinuation of a medication when it is no longer needed or when its risks may outweigh its benefits. The KFF Health News report says the practice has gained momentum over the past decade as multiple medication use and associated concerns have grown.
The report also describes 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 taper medicines when appropriate. Providers had previously reported uncertainty about reimbursement for this work, which can be time-intensive. The report notes a separate, politically contested debate over psychiatric medications, including Health and Human Services Secretary Robert F. Kennedy Jr.’s calls to reduce their use; that advocacy is distinct from the clinical process of reviewing an individual patient’s medicines.
““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
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What the Report Does Not Establish
The report does not quantify how many medication-related harms could be prevented through reviews or deprescribing, and it does not establish that taking five or more medicines is unsafe for every person. The cited figures describe medication use, not the rate of harmful interactions. A person’s need for a medicine depends on their diagnoses, benefits, risks and treatment plan.
The source also does not specify the full details or implementation effects of the CMS guidance, such as how widely clinicians will use the payment provisions. Nor does it give a universal schedule for tapering particular drugs. Decisions about whether and how to reduce medication need to be made individually with clinicians; the report’s patient examples and expert comments do not establish that a specific medicine should be stopped for other people.
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Bring a Medication List to Care
People concerned about their medication mix can prepare an up-to-date list of prescriptions, over-the-counter drugs, vitamins and supplements and share it with their primary care provider, specialists and pharmacist. They can ask whether each medicine is still needed, whether a new symptom might be a side effect, and whether any combination warrants review.
If a clinician recommends a change, patients should ask what to expect and whether the medicine needs a gradual taper. The report offers no fixed timetable for follow-up; next steps depend on the medication and the patient’s health. Its central advice is to make the concern part of a clinical conversation and not stop or reduce a prescribed drug without professional guidance.
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Key Questions
What does deprescribing mean?
Deprescribing is a planned process for reducing or stopping a medication when a clinician and patient decide it may no longer be needed or its risks warrant a change. Some medicines require tapering.
Does taking five or more medications mean a person should stop one?
No. The report uses five or more medicines to describe polypharmacy and its prevalence among older adults; it does not say that this number alone makes a treatment inappropriate. Medication decisions depend on individual circumstances.
What should I include on a medication list?
List prescription medicines, over-the-counter products, vitamins and supplements, and keep the information current. Bring it to medical appointments and share it with clinicians and pharmacists involved in your care.
Should I stop a medication if I suspect a side effect?
Contact your prescribing clinician or another qualified health professional to discuss the symptom and possible next steps. Do not stop or change a prescribed dose on your own; some medicines need to be tapered or replaced under professional guidance.
Source: rss
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