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 systematic review including more than 34,000 older adults, researchers measured the benefits and risks of deprescribing. All study participants had a medication review and at least one of their prescribed medications withdrawn.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 (6).
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). While this review looked at folks in multiple settings, such as hospitals, residential care, and the community, a second review focusing specifically on community-dwelling older adults also found that comprehensive medication review and deprescribing may lead to a small decrease in death, but this time little-to-no effect on falls (7). Encouragingly, stopping unnecessary medications did not increase risk of drug withdrawal or affect quality of life (6).
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 Medication Appropriateness and Deprescribing Network are are to promote appropriate medication use and to ensure access to safer drug and non-drug therapies (8).
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.
