Dr. Sascha Dublin explains why sometimes not taking medications may be a safer and healthier choice
Recently, The New York Times posted a story about a common danger for older adults — taking more medications than necessary. I read the story with interest because I help lead an initiative it describes: the U.S. Deprescribing Research Network. Our goal is improving medication use and outcomes for older adults.
Older adults often take more medications than they need, or than is safe. Increasingly, geriatric experts and their patients are exploring the benefits of “deprescribing.”
The last straw, for Leslie Hawkins, was her mother’s 93rd-birthday gathering in 2018.
Her mother, Mary E. Harrison, had long contended with multiple health problems, including diabetes and the nerve pain it can cause; hypertension; anxiety; and some cognitive decline. She was prone to falling.
When you’re thinking about taking a new medicine, the list of possible side effects can look endless—and scary. Drug labels list an average of 70 (and as many as 525), according to one study.
“The more medications a person takes, the greater the chance at least one will cause an adverse effect,” says Michael Steinman, M.D., a professor of medicine in the geriatrics division at the University of California, San Francisco, School of Medicine. “Plus, medicines can interact with each other such that the combination causes problems.”
- Experts say many older adults who are taking a number of prescription pills can develop a “medication fog” that mimics dementia symptoms.
- Experts say pain medications, sleep medications, and antidepressants are some of the prescriptions that can cause this fog.
- Experts say older adults and their caregivers should research medications as well as set up an appointment with a doctor to specifically discuss the prescriptions.
“Tell me about the problems you have with your medications.” A simple open-ended question that is probably rarely asked, but goes beyond the traditional problems that clinicians worry about, like non-adherence, inappropriate prescribing, and adverse reactions.
What do you find when you go deeper? Well we talk with Francesca Nicosia and Mike Steinman about the work they have done around deprescribing and medication related problems…
Claire Dinneen’s daughters thought that worsening dementia was causing her growing confusion, but her doctor suspected something else.
Dr. Pei Chen asked them to round up medicines in the 89-year-old woman’s home and they returned with a huge haul. There were 28 drugs ordered by various doctors for various ailments, plus over-the-counter medicines. Chen spent a year sorting out which ones were truly needed and trimmed a dozen…
More than 40 percent of U.S. adults aged 65 and older take five or more prescription drugs. That’s according to a 2017 report from the U.S. Department of Health and Human Services, which found that so-called “polypharmacy” is on the rise. But some experts are concerned about the medical risks of overprescription, which can happen when patients rely on automated refill services or see multiple specialists. We’ll talk to UCSF’s Michael Steinman…
Here’s a familiar sight in many doctors’ offices after the holidays: Someone shows up with an older family member and dumps the contents of a paper bag filled with medications onto the exam table — drugs they’ve found in their parent’s or grandparent’s medicine cabinet during a Christmas visit…