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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 interviewed say patients can ask their doctors or specialists to review their medication lists and discuss whether any drugs can be tapered safely; patients should not stop medicines on their own.
A KFF Health News report is drawing attention to the risks of taking multiple medications, including harmful interactions, and says patients concerned about side effects can ask their clinicians about deprescribing—a planned, medically supervised reduction or discontinuation of a drug when appropriate. The report describes a Pennsylvania man whose liver and kidney function returned to normal after doctors changed medications following a harmful interaction.
Jonathan Bledsoe of Reading, Pennsylvania, had taken a medication to stabilize his mood and another to manage cholesterol, along with several other medicines, for nearly three years. He sought medical help after noticing that his urine had turned dark. Bledsoe said doctors determined that an interaction among his medications was beginning to damage his liver. After the medications were changed, his liver and kidney function returned to normal, according to the report.
The report cites a study published in JAMA Internal Medicine that found the share of Americans over 65 taking five or more medications nearly doubled between 2000 and 2020. More than a third of older adults now take at least five medications a day, the report says. 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 or filled at different pharmacies.
Mixon said the likelihood of medications interacting and causing side effects rises as patients accumulate prescriptions over time. The report also describes “prescribing cascades,” in which a side effect from one medicine prompts another prescription, potentially adding further effects to manage. Its practical advice is to maintain an up-to-date list of prescriptions, vitamins and supplements and bring it to appointments.
Medication lists can become fragmented when a person sees multiple prescribers or health systems, whose records may not be connected. Pharmacist DeLon Canterbury, who runs the medication consulting company GeriatRx, cautioned that patients should not assume someone is routinely checking every medicine for interactions across those systems. A current list gives clinicians information they may not otherwise have when evaluating a new symptom or side effect.
The report frames deprescribing as a question of patient safety, not simply reducing the number of pills. Canterbury said age can change how the body processes medications, potentially contributing to effects such as constipation, diarrhea, falls or memory loss. A clinician can weigh whether a medicine remains beneficial, whether a symptom could be a side effect and whether a safe taper is appropriate. The article does not recommend stopping a prescription without medical guidance.
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How Deprescribing Entered the Conversation
Deprescribing means intentionally reducing or stopping a medication, usually through a plan that accounts for its purpose and the risks of changing it. The report says interest in the practice has grown over the past decade as use of multiple medications and concerns about their associated risks have increased. Canterbury said safe tapering is a newer area of practice and is not yet widely taught in medical schools.
The report 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 guidance followed uncertainty among physicians about payment for what can be a time-intensive process. Separately, Health and Human Services Secretary Robert F. Kennedy Jr. has advocated weaning Americans off psychiatric medications he says are overused, a position the report says has polarized the medical community. The report’s advice focuses on individual clinical review rather than broad, automatic medication reductions.
“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 Medication Changes Require Review
The report does not identify which medicines caused Bledsoe’s interaction, describe the specific changes doctors made or provide details about his treatment. It also does not establish how frequently medication interactions cause harm across the population. The cited study measures the share of older adults taking five or more medications; it does not, by itself, show that every person taking that number faces an adverse interaction.
Whether a medicine can be reduced or stopped depends on the patient and the reason it was prescribed. The report offers no universal tapering schedule, and Canterbury said the science on safe tapering is still developing. It is also unclear how the new federal payment guidance will affect access to medication reviews in practice. Patients should discuss concerns with a prescribing clinician rather than stopping or changing a dose on their own.
deprescribing medication guidebook
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Bring the Full List to Your Clinician
For a patient worried about a new symptom, side effect or growing number of prescriptions, the report recommends starting a conversation with a primary care provider or relevant specialist. Bring a current list of prescription drugs, over-the-counter medicines, vitamins and supplements, including medicines prescribed by other clinicians. A paper list is sufficient; the report also mentions tracking apps and QR-code bracelets as options.
Clinicians can review what each medicine is for, consider possible interactions and decide whether any changes are appropriate. If a drug should be tapered, the report describes that as a planned process rather than an abrupt, self-directed change. The effects of the CMS guidance and the wider adoption of deprescribing practices remain to be seen.
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Key Questions
What does deprescribing mean?
Deprescribing is the planned reduction or stopping of a medication when a clinician determines it may be appropriate. The report says tapering can require a medical plan; it is not a recommendation to stop medicines without professional guidance.
Why can taking several medications raise concerns?
According to clinicians interviewed by KFF Health News, more medications can increase the chance of drug interactions and side effects. The concern can be harder to assess when medicines come from different prescribers or health systems.
What should I include on a medication list?
List prescription medicines, over-the-counter drugs, vitamins and supplements. Keep it current and bring it to appointments so clinicians can review the full mix, including items prescribed elsewhere.
Should I stop a medication if I suspect a side effect?
No. The report advises raising new symptoms or side effects with a doctor or specialist. A clinician can assess the cause and discuss whether a change or supervised taper is suitable.
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