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A KFF Health News report highlights risks that can come with taking several medications and encourages patients who have concerns to discuss a medication review with their clinicians. More than one-third of adults over 65 take at least five medications, according to a study cited in the report. Patients should not stop or taper a drug on their own; the goal is a clinician-guided review of whether each medication remains appropriate.
A KFF Health News report highlights the risks of taking multiple medications and urges people concerned about side effects or drug interactions to raise a clinician-guided medication review. The report cites research finding that more than one-third of adults over 65 take five or more medications, a pattern known as polypharmacy.
The report describes Jonathan Bledsoe, a Marine veteran from Reading, Pennsylvania, who took several medications, including prescriptions for mood stabilization and cholesterol. After he noticed that his urine had turned dark, he brought the symptom to his doctors. He learned that an interaction between his medications was beginning to damage his liver. After his medications were changed, the report says, 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 from 2000 to 2020. The report says more than one-third of older adults now take that many medications. 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.
The report explains that a prescribing cascade can occur when a drug’s side effect is treated with another medication, which may then cause further problems. Mixon gives the example of a water pill used by some people with heart failure: increased urination can contribute to incontinence, which may lead to another prescription. The report recommends keeping a current list of prescriptions, vitamins and supplements and bringing it to appointments. Patients worried about a drug should raise the concern with their prescriber rather than stopping it without advice.
When Multiple Prescriptions Overlap
Each additional medication can make it harder for a patient or clinician to spot which drug may be contributing to a new symptom, particularly when care comes from several prescribers or health systems. Mixon said the chance of interactions and adverse effects rises as medications accumulate. The report identifies possible effects in older adults that include falls, memory loss, constipation and diarrhea.
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. It is not a push to remove as many drugs as possible. The report stresses that the purpose is patient safety, with decisions made in consultation with the people managing a patient’s care.
For readers, the practical implication is to make medication questions part of routine care, especially after a new symptom, a change in health, or a prescription from a different provider. A shared, accurate medication list can help clinicians review what a patient is taking, though the report cautions that patients should not assume someone else is checking every possible interaction across separate records.
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How Deprescribing Entered the Conversation
The report describes deprescribing as a practice that has gained momentum over the past decade, alongside increased use of multiple medications and concerns about their risks. DeLon Canterbury, a pharmacist and head of North Carolina-based consulting company GeriatRx, said safe tapering is a relatively new area of practice and is not widely taught in medical schools. That can make a planned review and reduction more involved than simply removing a prescription.
Medication reviews can also be complicated when providers work in separate health systems whose records do not capture every prescription. Canterbury said patients should not assume that a pharmacist or doctor has a complete view of all their medications. The report recommends bringing a list to appointments; it can be written on paper or kept using an app or another method the patient can maintain.
The report also notes a policy development: 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. The guidance addresses earlier uncertainty among physicians about payment for what can be a time-intensive process. It does not, by itself, determine which medication an individual patient should stop.
““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
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What a Medication Review Can Establish
The report does not identify which medications, doses or combinations pose the greatest risk across the population, and the cited figures on polypharmacy do not show how many people experience an adverse interaction. Bledsoe’s case illustrates one reported outcome; it does not establish that every patient taking several medications will be harmed.
Whether a particular prescription should be reduced or stopped depends on the patient’s health, the medication’s purpose and possible risks of changing it. The report does not provide a universal tapering schedule. It also does not detail how the CMS guidance will affect access to medication reviews or payment in individual cases. Patients should discuss changes with a qualified clinician and should not stop a prescribed drug abruptly without medical advice.
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Bring a Complete List to Your Clinician
People concerned about a new symptom, side effect or growing list of prescriptions can ask a primary care provider or specialist to review every medication, including over-the-counter products, vitamins and supplements. The report recommends keeping that list updated and carrying it to appointments so providers can see what is being taken across different prescribers.
Patients can ask whether each medication still has a clear purpose, whether it could be contributing to a symptom, and whether a dose change or supervised taper is appropriate. Clinicians should guide any reduction, since safe tapering depends on the medication and the person’s circumstances. The next step for patients is a direct conversation; the report offers no single timetable for reviews or for the effects of the federal payment guidance.
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Key Questions
What does polypharmacy mean in this report?
Polypharmacy refers here to taking five or more medications. The report cites research finding that more than one-third of adults over 65 take at least that many.
What is deprescribing?
Deprescribing is the planned reduction or discontinuation of a medication when a patient and clinician determine that a change is appropriate. It should be guided by a qualified health professional, not done abruptly on a patient’s own.
Should I stop a medication if I suspect a side effect?
No. Contact the prescriber or another qualified clinician to discuss the symptom and the medication. The right response can depend on the drug and your health; stopping or tapering without medical guidance may be unsafe.
What should I bring to a medication review?
Bring an up-to-date list of prescription drugs, over-the-counter medicines, vitamins and supplements, including medications from other clinicians. The report says a paper list or an app can help, as long as it is current and available at appointments.
Does the CMS guidance mean medication reviews are now covered for everyone?
The report says CMS issued guidance this year clarifying how physicians and pharmacists can be paid for medication reviews and appropriate tapering help. It does not establish from the information provided that every review is covered for every patient or in every circumstance.
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