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A KFF Health News report describes how taking multiple medications can increase the chance of harmful interactions and side effects, particularly for older adults. Clinicians quoted in the report recommend keeping a current list of prescriptions and supplements and asking a doctor or pharmacist whether a medication review or supervised taper is appropriate.
A KFF Health News report is drawing attention to the risks of taking multiple medications, including possible interactions and side effects, and encourages patients who are concerned to discuss their prescriptions with a clinician. The report describes a Pennsylvania man’s liver injury linked to a medication interaction and notes that more than a third of adults over 65 take five or more medications a day, according to a study cited in the report.
Jonathan Bledsoe, a Marine veteran from Reading, Pennsylvania, told the report that he had taken medication to stabilize his mood and lower his cholesterol, along with other drugs, for nearly three years. When he noticed his urine had turned dark brown, he contacted his doctors. He learned that an interaction between his medications was beginning to damage his liver, the report said. After his medications were changed, his liver and kidney function returned to normal.
Amanda Mixon, a hospitalist and associate professor of bioinformatics at Vanderbilt University, said the chance of harmful interactions can rise as people take more medications. She told KFF Health News that she sees older patients taking an average of 16 medications, often prescribed by multiple clinicians and filled at multiple pharmacies. The report also cites a JAMA Internal Medicine study finding that the share of Americans over 65 taking at least five medications nearly doubled between 2000 and 2020.
The report explains that a prescribing cascade can occur when a side effect from one drug is treated with another medication, potentially adding further side effects. Deprescribing means intentionally reducing or stopping a medication when a clinician determines it is appropriate. Pharmacist DeLon Canterbury said patients can raise concerns with their primary care provider or specialist, particularly if they notice a new symptom or unexpected side effect. Medication changes should be planned with a health professional; the report does not advise patients to stop drugs on their own.
Why Medication Reviews Matter
Medication reviews can help patients and clinicians identify possible interactions, side effects, duplicate treatments or medicines that may no longer be needed. This is especially relevant when a person receives care from multiple prescribers who may not share the same health records. Canterbury cautioned that patients should not assume a pharmacist or another clinician has checked every medication across their care.
The report frames deprescribing as a safety conversation, not a goal of reducing the number of medicines at any cost. Some treatments provide substantial benefits, and stopping or tapering certain drugs without guidance can be unsafe. The relevant question is whether each medication remains appropriate for the individual, given their current health, other treatments and any symptoms they are experiencing.
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How Multiple Prescriptions Accumulate
Polypharmacy is commonly used to describe taking several medications; the report focuses on the threshold of five or more medicines when discussing older adults. It says the share of Americans over 65 at that threshold nearly doubled from 2000 to 2020, based on the cited JAMA Internal Medicine study. Mixon described patients whose medicines accumulate over time as different conditions are treated.
The report notes that deprescribing has gained momentum over the past decade, alongside growing attention to polypharmacy and its potential risks. Canterbury said the science on safe tapering is newer and is not yet widely taught in medical schools. The article also reports that the Centers for Medicare & Medicaid Services issued guidance this year clarifying how physicians and pharmacists can be paid for medication reviews and appropriate tapering support. The source material does not give the guidance’s date or detailed provisions.
““As you accumulate more and more medications, the chance of them interacting with each other and having bad interactions increases.””
— Amanda Mixon, hospitalist and associate professor of bioinformatics at Vanderbilt University
pill organizer with medication list
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What the Report Does Not Establish
The report does not quantify how often medication interactions cause serious harm across the population, nor does it say how many patients would benefit from deprescribing. Bledsoe’s experience is an individual case; it does not establish that every person taking several medications faces the same outcome. The cited statistics describe medication use, not the rate of injury.
The source also does not specify which medicines Bledsoe took, the precise interaction involved or the timeline for his recovery. It gives no details on how widely medication reviews are available or how the new Medicare guidance will affect access. Decisions to reduce or stop a prescription depend on the patient’s circumstances and require clinical guidance.
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Steps Patients Can Take With Clinicians
The report recommends maintaining an up-to-date list of prescriptions, vitamins and supplements and bringing it to appointments. Patients who notice a new symptom or suspect a side effect can ask their primary care provider, specialist or pharmacist to review the complete list and explain whether any medicines may interact.
If a clinician believes a medication should be reduced or stopped, the patient and care team can discuss a plan for doing so safely and monitor how the patient responds. The report does not identify a particular next policy deadline or clinical milestone. The timing and availability of future reviews will depend on patients’ care teams and how medication-review services are delivered.
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Key Questions
What does deprescribing mean?
Deprescribing is the planned reduction or stopping of a medication when a clinician determines it may no longer be needed or may pose more risk than benefit. It should be discussed with a health professional, rather than attempted independently.
Should I stop a medication if I am worried about side effects?
Do not stop or change a prescribed medication without consulting a clinician. Contact your doctor or pharmacist to describe the symptom and ask whether the medication or its interaction with another drug could be involved.
What should I include on a medication list?
List all prescription medicines, over-the-counter drugs, vitamins and supplements. Keep the information current and bring it to medical appointments so clinicians can review the full set of products you take.
Why can multiple prescribers make medication review harder?
Clinicians working in separate health systems may not have access to the same patient records, according to the report. Sharing a complete medication list can help the care team identify possible interactions or overlapping treatments.
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