Do you take medicine to live, or do you live to take medication?
Many older patients take multiple medications that are sometimes no longer needed or may cause more harm than good. Medicines are started with the intent to control symptoms or prevent or slow down the progression of the disease. However, not all of them are always needed lifelong. Also, medical conditions change as people age, and the same medications that worked well before may not be the best choice anymore.
Drugs may also cause more harm over time, and older people are at more risk for injury because they respond to and handle medicines differently. They could be more sensitive to side effects and have a more challenging time eliminating drugs from the body. Side effects of meds can contribute to many problems in older people, like falls and confusion.
When the risk of medicine outweighs its benefits, we call this problem polypharmacy. This is especially problematic for older people that are frail. Many times, the side effects of taking the medication dramatically outweighs the benefit of taking the drug. Deprescribing is a planned and supervised process of dose reduction or stopping medication that may be causing harm or is no longer beneficial—in other words, reducing medications safely to meet life’s changes. The goal is to reduce patients’ pill burden while maintaining or improving quality of life and overall health.