TL;DR
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A KFF Health News report describes growing concerns about medication interactions as more older adults take multiple prescriptions. Experts say patients can ask a doctor or pharmacist to review their medications and discuss whether any can be safely reduced; they should not stop medicines on their own.
A KFF Health News report highlights the risks of taking multiple medications and advises people concerned about side effects to ask their clinicians for a medication review, including whether any prescriptions can be safely reduced. The report describes a Pennsylvania man whose doctors traced liver damage to an interaction between medications, while experts warn that prescriptions from multiple providers can make interactions and unintended side effects harder to spot.
Jonathan Bledsoe, a Marine veteran from Reading, Pennsylvania, told KFF Health News that he had taken a medication to stabilize his mood and another to manage cholesterol, along with other medicines, for nearly three years. When his urine turned dark brown, he raised the symptom with his doctors. They found that an interaction between his medications was beginning to damage his liver, he said. After he changed medications, 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 and filled at different pharmacies.
Taking several medicines does not by itself mean a person is being harmed or should stop treatment. But medication combinations can produce side effects or interactions, and prescriptions may accumulate over time. One pattern, called a prescribing cascade, occurs when a side effect from one medicine is treated with another prescription, potentially adding further risks. The report gives the example of a water pill used for heart failure that increases urination; incontinence may then be treated with another medication.
Why Medication Reviews Matter
The report’s central concern is not that older adults should take fewer medicines at any cost. It is that patients and clinicians need to regularly check whether each medicine remains appropriate, particularly when a person has several prescribers or develops a new symptom. A review can help identify possible interactions, medicines that may no longer be needed, or side effects that could be mistaken for a new health problem.
Age can change how the body processes medications, pharmacist DeLon Canterbury told KFF Health News, which may raise the likelihood of unwanted effects such as constipation, diarrhea, falls, or memory problems. Those symptoms can affect daily life and may prompt additional treatment. The report emphasizes that the goal of deprescribing—intentionally reducing or stopping a medication under clinical guidance—is patient safety, not simply cutting the number of prescriptions.
Patients can help clinicians see the full picture by keeping an up-to-date list of prescriptions, over-the-counter medicines, vitamins, and supplements. That is particularly useful when care is spread across different health systems whose records may not be connected. A review should involve the clinicians responsible for the relevant conditions, since stopping or changing a medication without professional guidance could create health risks.
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How Prescriptions Can Accumulate
People with multiple health conditions may receive medicines from several specialists and primary care providers. Canterbury, who leads GeriatRx, a consulting company focused on helping patients reduce unnecessary medication, said separate health systems may have separate patient records. That can leave clinicians without a complete view of what a patient takes. He cautioned patients not to assume that a pharmacist or another provider is automatically checking every medication combination.
Deprescribing has gained attention over the past decade alongside rising polypharmacy and concerns about associated risks, according to the report. Canterbury said the evidence and training on how to taper medications safely are newer and are not yet widely taught in medical schools. The process can take time: a clinician may need to assess why a drug was prescribed, weigh possible benefits and harms, and plan how to reduce it safely if a change is appropriate.
The policy backdrop is also evolving. The report says the Centers for Medicare & Medicaid Services issued guidance this year clarifying how physicians and pharmacists may be paid for medication reviews and helping patients taper medicines when appropriate. Previously, clinicians had reported uncertainty about whether they could be reimbursed for this time-intensive work. Separately, Health and Human Services Secretary Robert F. Kennedy Jr. has advocated reducing psychiatric medication use, a position that has polarized the medical community, the report says.
““As you accumulate more and more medications, the chance of them interacting with each other and having bad interactions increases.””
— Amanda Mixon, a hospitalist and associate professor of bioinformatics at Vanderbilt University
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What Individual Reviews Can Determine
The report does not identify a single medication count that is unsafe for everyone. Risk depends on a person’s health, the medicines involved, their doses, and how those medicines are taken. Nor does it say that every older adult taking five or more medications is experiencing an adverse interaction. The cited population data describe medication use, not the number of people harmed.
It is also unclear how widely the new federal payment guidance will change access to medication reviews or how many clinicians will use it. The report notes that safe tapering practices are not yet widely taught, but does not quantify how often patients receive deprescribing discussions. Patients should not independently stop, reduce, or change a prescribed medication; the appropriate plan depends on an individual clinical review.
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How Patients Can Start a Review
People worried about a new symptom, a possible side effect, or a growing list of medicines can bring the concern to a primary care provider or the specialist who prescribed the medication. The report advises asking whether the medicines remain necessary, whether any could be interacting, and whether a supervised taper or alternative treatment is appropriate. Patients can bring an updated list of all prescriptions, nonprescription medicines, vitamins, and supplements, along with details about when symptoms began.
Any change should be planned with a qualified clinician, who can explain what to monitor and whether follow-up is needed. The report does not announce a new medical rule or a deadline for action. Its practical recommendation is to start a conversation and keep medication information current as care continues across providers.
deprescribing medication guidebook
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Key Questions
What does deprescribing mean?
Deprescribing is the planned reduction or stopping of a medication when a clinician determines that a change may be appropriate. It is not simply taking fewer medicines without medical guidance.
Should I stop a medicine if I suspect a side effect?
No. Contact the prescribing clinician or another qualified health professional to discuss the symptom and possible next steps. Do not stop or change a prescribed medicine on your own, because the safest approach depends on the medication and your health.
What should I bring to a medication review?
Bring an up-to-date list of prescriptions, over-the-counter medicines, vitamins, and supplements, including doses if available. Mention new or unexpected symptoms and when they began.
Does taking five or more medications mean someone is being harmed?
No. The report uses five or more medications as a measure of polypharmacy; that count alone does not establish that a person is experiencing harm. A clinician can review whether each medicine is appropriate and whether interactions or side effects are a concern.
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