Medication Review

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Is it time for a medication review?

 

Apr 10, 2017 – McMaster University –

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 All study participants had a medication review and at least one of their prescribed medications withdrawn.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.

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