Why we can’t ignore medication overload

By Judith Garber | September 10, 2019

Earlier this year, the Lown Institute released a report on the growing epidemic of medication overload among older adults. However, Lown is just one of many organizations concerned with harmful polypharmacy. The John A. Hartford Foundation is dedicated to improving the care of older adults, and has developed a framework for Age-Friendly Health Systems. On the Institute for Healthcare Improvement blog, Dr. Terry Fulmer, President of the Hartford Foundation explained in an interview why tackling medication overload is necessary for the health of older adults.

Older adults are more susceptible to medication overload than younger adults, because they take more medications on average and have reduced ability to process medications compared to younger adults, said Fulmer. Not only are older adults at greater risk of side effects than younger adults, but the consequences of these side effects may be greater as well.

“I’m a practicing nurse and I see how taking multiple medications can cloud a patient’s cognition,” said Fulmer. “If they fall, they’re more likely to suffer a hip fracture than a younger person.”

Medication is one of the “the 4Ms” the Hartford Foundation recognizes as being critical to creating Age-Friendly Health Systems, along with Mentation, Mobility, and what Matters to the patient. Making sure patients’ medications are working for them is essential, because medication overload can affect not only physical health, but mental health, financial security, and the ability to enjoy everyday activities.

“Getting medications right is essential because when your medication is wrong, your mentation can be off, your mobility can be compromised, and what matters to you will not be front and center,” said Fulmer.

Read Dr. Fulmer’s full interview on the IHI blog!

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.