Boston Globe features Lown medication overload project

By Judith Garber | January 17, 2020

Maureen Dixon, 67, of Medford, Massachusetts, takes a half-dozen pills and three injections every day, along with an assortment of vitamins recommended by doctors over the years. As the Boston Globe recently reported, she goes to great lengths to keep her many medications organized, but still worries sometimes about adverse drug events.

Maureen is far from alone. Two-thirds of older Americans take five or more medications, including over-the-counter drugs and supplements. Last year, the Lown Institute published a report exposing the hidden epidemic of medication overload, harm caused by too many medications, in older adults. At the end of the month, Lown will be publishing a follow-up document, a comprehensive action plan with recommendations for eliminating medication overload. The Boston Globe gave a sneak peek of what the action plan will cover:

“In addition to sounding the alarm on what it terms ‘America’s harmful culture of prescribing,’ the action plan will call for educating and training health professionals on adverse reactions stemming from the interaction of multiple medicines… The plan will also advocate plugging information gaps — often caused by a lack of coordination in electronic medical records — so specialists know all the meds their patients are taking. And it will champion ‘prescription checkups’ where primary care docs regularly review their patients’ drug inventories with an eye toward pruning or cutting doses.”

“We want patients to think it’s OK to question whether they need to be on all the drugs they’re on,” said Shannon Brownlee, Lown senior vice president, in the Globe. “We want doctors to think twice before prescribing new medicines. And we want it to be a normal part of a primary care physician’s practice to regularly see if there’s a way to get patients off one or more drugs.”

This story sparked a lively discussion on the Boston Globe website, with more than 30 comments in the first few days after publication. Many of the comments were from people who had themselves suffered harm from medication side effects or had difficulty managing their medications.

For example, user “OkraEater” wrote, “Too many medical specialists see patients as only one organ, the organ they specialize in. I have suggested to physicians that one medicine I take might create a side effect with some other, prescribed by another physician. Each says I should talk with the other about not taking the other medication.”

User Eastsight illustrated the prescribing cascade in their social circle: “I know too many people who take a drug for X condition, but the drug has side effect Y so my friends take another drug to alleviate Y which has side effects so on to drug Z.”

Read the article on the Boston Globe website to join the conversation. And stay tuned for our action plan release on January 28th!

To eliminate medication overload, serious cultural, educational, and policy changes are needed. This action plan offers recommendations for policymakers, health care institutions, clinicians, and patients across five key categories to reduce harm from multiple medication use. Suggested Citation: Eliminating medication overload: A national action plan. Working Group on Medication Overload. Brookline, MA: The Lown Institute, 2020. DOI: https://doi.org/10.46241/LI.YLBW4885

Pharmaceutical marketing is a significant factor in the growing public health crisis of medication overload, which puts millions of older adults at risk of preventable harm and premature death. This issue brief provides recommendations to reduce pharmaceutical industry influence by limiting pharma sales rep visits to clinicians and direct-to-consumer advertising.

This issue brief provides recommendations for clinical practice guidelines and electronic health records that would give clinicians the information they need to appropriately prescribe and deprescribe.