Medication Overload

 This is National Pharmacy Week (October 18-24) so it seems like a good time to talk about the risks associated with taking too many medications. The past few decades have seen a tremendous jump prescription drug use. In 1994, just under 14% of older adults were taking five or more drugs. Today, more than four in ten older adults today fit this profile. If you include over-the-counter medications and supplements, the number rises to 67 percent. 

Scientists call the use of five or more prescription medications a day polypharmacy. Of course, medications improve many people’s lives, and for those who have more than one chronic disease, multiple drugs may be necessary and beneficial. However, taking multiple medications increases one’s risk of suffering serious, sometimes life-threatening side effects.  

Medication Overload is the term for the use of multiple medications for which the harm to the patient outweighs the benefit. There is no strict cutoff for when the number of medications becomes harmful, but the greater the number, the greater the likelihood of experiencing harm, including serious adverse drug events. In fact, the risk of an adverse drug event increases by 7-10% with each medication one takes. Every day, 750 people age 65+ in the US are hospitalized due to serious side effects from one or more medications.  

Falls, delirium and death all increase with medication overload. Taking ten or more medications or more is associated with a 50% higher risk of falls, a 2.5 times greater likelihood of experiencing delirium compared to those taking fewer than five drugs, and a 96 percent greater chance of death! 

We reached out about this topic to Age-Friendly Buncombe partner, Dr. Tasha Woodall, a Board-Certified Geriatric Pharmacist and Co-Director of for MAHEC’s Center for Healthy Aging. “Thankfully,” she said, “there’s a solution. Health care providers can partner with their patients and their families to create a plan for “de-prescribing” medications that can be harmful or have outlived their usefulness.” 

Experts generally agree that older adults who take one or more drugs on a long-term basis should have an annual review of their medications, or prescription checkup. A prescription checkup involves reviewing a patient’s list of medications and the reasons they were prescribed and reducing the dose or stopping or pausing those that are ineffective or harmful.  

To learn more, check out www.deprescribing.org    

We wish to acknowledge the Lown Institute and their work on medication overload for this blog post.