Every day, millions of Americans take medications to manage chronic conditions or prevent disease. Prescription drugs are vital tools in modern medicine, but in some circumstances, they can also lead to serious adverse drug interactions, diminished quality of life, and even life-threatening complications.
This is a complex issue with high stakes for patients. Older adults, in particular, are often prescribed multiple drugs by different doctors for different reasons. The Centers for Disease Control and Prevention reports that nearly 70 percent of adults aged 40 to 79 years used one or more prescriptions in the past 30 days and over 20 percent used five or more prescriptions.
The risks of polypharmacy
Polypharmacy, the term for taking five or more medications, comes with risk. It disproportionately affects older adults and those with multiple conditions. For these patients, each additional pill can increase the risk of falls, cognitive decline, and adverse events, contributing to tens of thousands of emergency room visits and hospitalizations each year.
That’s why the American Medical Association is urging physicians and patients to embrace a concept gaining critical momentum in health care: deprescribing.
Understanding deprescribing
Deprescribing is the planned, supervised process of reducing or stopping medications that may no longer be beneficial, or may be causing harm. There are many reasons why a medication that was once appropriate may become unnecessary or even risky. A patient’s condition may have improved, and the medication is no longer needed. Or newer treatments may offer better outcomes in place of current medication. In addition, patients may have started to take new over-the-counter drugs or supplements.
Deprescribing is not about denying care or cutting costs at the expense of patient health. It’s about ensuring that every medication prescribed is truly necessary, evidence-based, and aligned with a patient’s current health goals.
It is important for patients to bring all their medications and non-prescribed therapies to each appointment to ensure physicians can provide individualized assessments and clear communication about which medications continue to be best for each patient.
Beyond symptom management
But here’s the bigger issue: If we truly want to reverse the tide of chronic disease in America, we need to go beyond managing symptoms. We need to rethink the entire approach, including how many medications a person is on and why. Of course, many conditions require lifelong treatment. But we need to talk more honestly about the role of lifestyle as essential components of healing and prevention:
- Nutrition
- Physical activity
- Sleep
- Stress management
- Social connection
Right now, lifestyle interventions are too often an afterthought, if they’re mentioned at all. But no amount of medication can fully counteract the health consequences of poor diet, inactivity, or chronic stress. Rebuilding our nation’s health means re-centering our care around what actually restores health, not just what controls disease.
Good medicine means knowing when to say, “Let’s take another look.” Physicians and care teams need to evaluate medications more holistically. And we need to encourage open conversations between doctors and patients about medication goals, side effects, and overall quality of life.
Systemic support needed
This cannot happen in isolation. We need insurers to support time for thoughtful medication reviews. We need better coordination across specialties and care settings. We need electronic health record developers to follow government rules and allow users to reconcile a patient’s active medication list, correct inaccuracies, and include non-prescription medicines and dietary supplements.
Deprescribing is not about withholding care; it’s about delivering the right care, at the right time, for the right reasons. And it’s about restoring balance, recognizing when a pill is helping, and when it’s just adding to the burden.
At its core, this is about respect: For the science, for the art of medicine, and most importantly, for the lives of our patients. If we’re serious about improving the health of our nation, then reassessing medications, and refocusing on the foundations of real health and collaboration with our patients, must become a routine part of how we practice medicine.
John Whyte is chief executive officer and executive vice president, American Medical Association. The American Medical Association is a professional association and lobbying group of physicians and medical students.
