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Is it time for a medication review? Many people take unnecessary meds

The Bottom Line

  • Older adults are particularly vulnerable to problems associated with polypharmacy (taking more than one medication at the same time).
  • Medication review by a doctor or pharmacist helps to assess the benefits and risks of prescribed drugs and reduce unnecessary medications.
  • Research shows that stopping unnecessary, inappropriate or potentially harmful drugs is a promising way to reduce risk of falls and prolong life, without significant risk of withdrawal.

How many pills do you take every day?


If you’re over the age of 65, chances are you’re regularly taking at least five and possibly upwards of 10 different prescription drugs (1, 2). As people get older and suffer more age-related health problems, they’re likely to continue adding to that collection of pill bottles on their night stand or pill shelf (1).


Those medications were likely prescribed for good reason, but over time some drugs may no longer be helpful, and in fact can even cause harm. For example, some medications can trigger bad reactions when combined with others or may cause side effects such as fuzzy thinking, weakness, falls, disability and even death (3, 4). That’s why “polypharmacy,” the use of multiple drugs at the same time, is recognized as a serious threat to quality of life and healthy aging.


What can we do about it?


A promising strategy is a multi-step process that begins with a review of your medications. A doctor or pharmacist can help assess the benefits and risks of each one and “deprescribe” any that are no longer appropriate (5). Deprescribing means backing off when doses are too high, or stopping medications that are no longer needed.


Considerable research has been conducted to find out if deprescribing is a safe approach and whether it helps to improve health and longevity. In a recent systematic review including more than 34,000 older adults, researchers measured the benefits and risks of deprescribing (6). All study participants had a medication review and at least one of their prescribed medications withdrawn. Researchers measured impacts on mortality (risk of death) and whether deprescribing had other impacts such as drug withdrawal or risk of falls.


What the research tells us

Medication review and deprescribing appear to be reasonable and safe ways to address polypharmacy in seniors. Review results suggest stopping one or more unnecessary medications can lead to health benefits such as fewer falls and may even increase your chance of living a longer life (6).


Encouragingly, stopping unnecessary medications did not increase risk of drug withdrawal or affect quality of life.


Reviewing medications – and deprescribing when warranted – has strong and growing support among doctors, geriatricians, pharmacists and other healthcare professionals concerned with the over prescribing and overuse of drugs. In Canada, the goals of the Canadian Deprescribing Network  are to reduce prescriptions of inappropriate medications by 50% by 2020 and to promote safer drug and non-drug therapies.


Wonder if you’d be better off with fewer pills? Start by asking your doctor or pharmacist for a medication review. Together, you can work on a plan to meet your health and wellness goals and safely reduce drugs you no longer need.


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References

  1. Canadian Institute for Health Information. Drug use among seniors on public drug programs in Canada, 2012.[Internet] 2014. [cited March 2017]. Available from https://secure.cihi.ca/free_products/Drug_Use_in_Seniors_on_Public_Drug_Programs_EN_web_Oct.pdf
  2. Hubbard RE, Peel NM, Scott IA et al. Polypharmacy among inpatients aged 70 years or older in Australia. Med J Aust. 2015; 202(7):373-378.
  3. Hilmer SN, GnjidicD. The effect of polypharmacy in older adults. Clin Pharmacol Ther. 2009; 85(1):86-88. Doi: 10.1038/clpt.2008.224.
  4. Jyrkka J, Enlund H, Korhonen MJ et al. Polypharmacy status as an indicator of mortality in an elderly population. Drugs Aging. 2009; 26(12):1039-1048. doi: 10.2165/11319530-000000000-00000.
  5. Scott IA, Hilmer SN, Reeve E et al. Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Intern Med. 2015; 175(5):827-34. doi: 10.1001/jamainternmed.2015.0324.
  6. Page AT, Clifford RM, Potter K et al. The feasibility and effect of deprescribing in older adults on mortality and health: a systematic review. Br J Clin Pharmacol. 2016; 82(3):583-623: doi: 10.1111/bcp.12975

DISCLAIMER: The blogs are provided for informational purposes only. They are not a substitute for advice from your own healthcare professionals.

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