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A KFF Health News report describes rising use of multiple medications among older adults and the risk of side effects and interactions. Health professionals quoted in the report say patients can ask their clinicians to review their full medication list and consider tapering drugs that are no longer needed; medication changes should be planned with a clinician.
A KFF Health News report highlights the growing use of multiple medications among older adults and the potential for harmful interactions, urging patients who notice new symptoms or side effects to ask their clinicians for a medication review. More than one-third of adults over 65 take five or more medications a day, the report says, citing a study in JAMA Internal Medicine.
The report describes Jonathan Bledsoe, a Reading, Pennsylvania, resident and Marine veteran who took medication for mood stabilization and cholesterol, among other drugs. After he noticed his urine had turned dark, he raised the symptom with his doctors and learned that an interaction between medications was beginning to damage his liver. The report says his liver and kidney function returned to normal after he changed medications. His experience illustrates a potential risk; it does not establish how common that outcome is.
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, according to the report. 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, often prescribed by multiple clinicians and filled at different pharmacies.
The report also describes a “prescribing cascade,” in which a side effect from one drug is treated with another medication, potentially adding further side effects. Deprescribing means intentionally reducing or stopping a medication when appropriate. The report stresses that the goal is patient safety, not reducing medication counts for their own sake, and that any changes should be discussed with a health professional.
Why Medication Reviews Matter
When patients receive care from multiple prescribers or health systems, no single clinician may have a complete view of every prescription, vitamin, and supplement they use. That can make it harder to spot potential interactions or understand whether a new symptom could be a medication side effect. Pharmacist DeLon Canterbury told KFF Health News that patients should not assume someone is checking every drug combination in the background.
Medication effects can also change with age, Mixon and Canterbury told the outlet. The report lists possible consequences of adverse effects in older adults, including falls, memory problems, constipation, and diarrhea. A regular review can give patients and clinicians a chance to weigh benefits against risks and discuss whether a medicine remains necessary. It cannot guarantee that an interaction will be found or that a drug should be stopped.
For patients, the practical point is to bring up concerns rather than stop a prescription on their own. A clinician can review the full list, consider possible causes of symptoms, and plan any tapering or substitution. The report says that safely reducing medication is a developing area of practice and may require time and coordination.
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How Deprescribing Entered the Discussion
The report says interest in deprescribing has grown over the past decade, alongside increased use of multiple medications and concern about related harms. Canterbury, who leads GeriatRx, a consulting company focused on helping patients get off unnecessary medications, said the science of tapering safely is newer and not widely taught in medical schools.
Medication oversight can be complicated when clinicians work in separate systems with separate records. The report notes that even a local pharmacy should not be assumed to have a complete record of all prescriptions from different providers. Keeping a current list of medications, including over-the-counter products, vitamins, and supplements, can help patients share a more complete picture at appointments.
The story 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 help with tapering when appropriate. The report says some clinicians had been uncertain about payment for this time-intensive work. It does not provide details on how widely the guidance has changed access to reviews.
“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 Is Still Uncertain
The report does not say how many medication-related harms are caused by interactions, or how often a medication review prevents them. The cited study measures the proportion of older Americans taking five or more drugs; it does not show that every person taking that number faces harm or needs to reduce their medications.
It is also unclear how broadly clinicians have adopted deprescribing practices or how CMS’s payment guidance will affect the availability of medication reviews. The report says safe tapering methods are still relatively new and are not widely taught. Decisions about whether to continue, change, or taper a medication depend on the individual patient and should be made with a clinician.
Discussing a Medication Review
People concerned about a new symptom, an unexpected side effect, or a long medication list can bring an updated record to a primary care clinician or specialist and ask whether each drug remains appropriate. The list should include prescriptions, nonprescription medicines, vitamins, and supplements, along with doses if known. A paper list is one option; the report also mentions medication apps and QR code bracelets.
Patients should not stop or taper a prescribed medicine without discussing a plan with a health professional. The next step depends on the clinician’s review, including whether a medicine may be contributing to a symptom and whether a gradual dose change or alternative is appropriate. The report does not identify a specific national deadline or further policy milestone.
Key Questions
What does deprescribing mean?
Deprescribing is the intentional reduction or discontinuation of a medication when a clinician and patient determine that doing so is appropriate. It is not simply stopping as many medications as possible.
How common is taking five or more medications among older adults?
According to the KFF Health News report, more than one-third of adults over 65 take five or more medications a day. A study in JAMA Internal Medicine found that the share nearly doubled from 2000 to 2020.
What should I include on a medication list?
Include prescription and over-the-counter medicines, as well as vitamins and supplements. Keep the list current and bring it to appointments so clinicians can review what you take.
Should I stop a medicine if I suspect a side effect?
Do not stop or taper a prescribed medication without consulting a qualified health professional. Tell your clinician about the symptom and ask whether a medication review or a supervised change is appropriate.
Does taking five or more medications mean someone should deprescribe?
No. The medication count alone does not determine whether a drug should be stopped. The report says deprescribing decisions should focus on individual safety and need and be discussed with the patient’s health professionals.
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