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A KFF Health News report describes the growing use of multiple medications among older adults and the potential for interactions and side effects. Clinicians quoted in the report recommend keeping an up-to-date medication list and raising concerns about deprescribing with a doctor or pharmacist; patients should not stop medicines on their own.
A KFF Health News report highlights the risks of taking multiple medications, including possible harmful interactions, and urges patients concerned about side effects to discuss a medication review or deprescribing with their clinicians. The report cites research showing that more than a third of adults over 65 take at least five medications a day, while emphasizing that medicines should not be stopped without medical guidance.
The report describes Jonathan Bledsoe, a Marine veteran in Reading, Pennsylvania, who said he took prescriptions for mood stabilization and cholesterol, among other medicines, for nearly three years. After he noticed that his urine had turned dark, he brought the symptoms to his doctors. He said they identified an interaction between his medications that was beginning to damage his liver. After his medications changed, his liver and kidney function returned to normal, according to the report.
Researchers have documented a rise in polypharmacy, commonly defined as taking five or more medications. A study published in JAMA Internal Medicine found that the share of Americans over 65 taking five or more medicines nearly doubled between 2000 and 2020. 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.
One concern is a prescribing cascade: a medicine causes a side effect, another drug is prescribed to treat it, and further effects may prompt additional prescriptions. Mixon gave the example of a water pill used for heart failure that increases urination; in some cases, incontinence may then be treated with another medication. The report does not suggest that every multi-drug regimen is inappropriate. It says the aim of deprescribing is to remove medicines that are no longer needed or may be causing harm, while maintaining appropriate treatment.
Why Medication Reviews Matter
Medication combinations can become harder to track when a person sees several prescribers or uses separate health systems with records that are not shared. Pharmacist DeLon Canterbury told the report that patients should not assume someone is checking every medicine and supplement for interactions. A symptom that appears after a medication change may warrant a conversation, though it does not by itself establish that a drug caused the problem.
Age can also affect how the body processes medicines, Canterbury said. The report lists possible side effects including constipation, diarrhea, falls and memory loss. These risks matter because an unnecessary or poorly coordinated medicine may affect daily functioning and safety. At the same time, medications can play an important role in treating disease and extending life; reviewing a regimen is not the same as automatically reducing it.
Deprescribing takes clinical judgment. Canterbury said safe tapering methods are newer and are not yet widely taught in medical schools. Patients should discuss changes with their prescribing clinician or pharmacist, who can weigh the reason for each drug, possible interactions and whether a gradual reduction is appropriate.
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How Deprescribing Entered the Discussion
The term deprescribing refers to intentionally reducing or stopping a medication when a clinician determines that doing so is appropriate. The report says the practice has gained attention over the past decade alongside growing concern about polypharmacy. It presents the process as a safety review rather than a campaign to eliminate as many medicines as possible.
The report also describes policy developments. Health and Human Services Secretary Robert F. Kennedy Jr. has called for reducing psychiatric medication use, a position that has polarized the medical community. Separately, 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 report says clinicians had previously been uncertain about payment for this time-intensive work.
For patients, one practical step recommended by pharmacists and doctors quoted in the report is to maintain a current list of prescriptions, over-the-counter drugs, vitamins and supplements. Pharmacist Jen Hammons, director of rural health advancement at the Appalachian College of Pharmacy, said a paper list can be enough if it is kept accessible and updated.
“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
What the Report Does Not Establish
The report does not quantify how often medication interactions cause serious harm, nor does the cited growth in polypharmacy show that every person taking five or more medicines faces the same level of risk. Individual risks depend on the medicines, doses, health conditions and other factors. Bledsoe’s account illustrates a reported case but cannot establish how common similar outcomes are.
The report also does not identify a single standard tapering plan for patients. Canterbury said safe deprescribing methods are still relatively new and not widely taught. Whether a particular medicine should be reduced or stopped, and how to do so safely, must be determined for the individual. The report advises discussion with clinicians rather than stopping treatment independently.
Next Steps for Patients and Clinicians
Patients worried about a new symptom, side effect or long medication list can bring an up-to-date inventory to a primary care clinician, specialist or pharmacist and ask for a review. The list should include prescriptions, nonprescription medicines, vitamins and supplements, along with doses when known. Patients can ask what each medicine is intended to treat and whether any may interact.
If a clinician recommends a change, patients should ask whether it needs to be tapered, what symptoms to watch for and when follow-up should occur. The report says CMS guidance clarifies payment for medication review and tapering services, but it provides no details about how widely that guidance will change access to such consultations. Further effects on clinical practice remain to be seen.
Key Questions
What does polypharmacy mean in this report?
It refers to taking five or more medications. The report cites research that found more than a third of adults over 65 take that many medicines a day.
What is deprescribing?
Deprescribing is the intentional reduction or discontinuation of a medicine when a clinician judges that change appropriate. It is a supervised review, not a recommendation to stop medicines without medical advice.
Should I stop a medicine if I think it is causing side effects?
No. The report recommends discussing concerns with the prescribing clinician or a pharmacist. Some medicines need to be tapered, and stopping without guidance may be unsafe.
What should I bring to a medication review?
Bring an updated list of prescription and over-the-counter medicines, plus vitamins and supplements. A paper list is one option; the report says the key is keeping it current and accessible.
Does taking five or more medicines mean a person is being overtreated?
No. The number alone does not establish that a regimen is inappropriate. The report says the goal of medication review is patient safety and determining whether each medicine remains needed.
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