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Don’t Be Fooled by Ads: Medication Overload Is Real

Polypharmacy is a devastating public health issue

By Terry Fulmer, PhD, RN, FAAN and The John A. Hartford Foundation
December 13, 2019
Credit: Adobe Stock

(Editor's note: This content is provided by The John A. Hartford Foundation, a Next Avenue funder.)

These days, you can't get through the evening news on television without being bombarded by drug advertisements. They promise everything from freedom from nerve pain to the end of anxiety-ridden afternoons. Watching these commercials can make you feel like you're not taking enough, or the right, medication.

In fact, nothing could be further from the truth.

Medication overload among older adults — also known as polypharmacy — is a real and devastating public health issue. As a recent report by the nonprofit Lown Institute noted, "Over the past few decades, medication use in the U.S., especially for older people, has gone far beyond necessary polypharmacy to the point where millions are overloaded with too many prescriptions and are experiencing significant harm as a result."

Those harms have a real-life impact on the nation's health system: Every day in America, 750 older adults are hospitalized due to side effects from one or more medications. And the Lown Institute predicts that in the next 10 years, 150,000 older adults will die prematurely due to medication overload.

As a practicing nurse who has long been concerned about medication problems among older adults, I'm committed to sounding the alarm about this problem — especially amid the ever-present onslaught of drug ads in peoples' lives and the lack of awareness of the dangers. A recent survey conducted by WebMD in partnership with The John A. Hartford Foundation found that 50% of older adult respondents didn't know that certain medications should be avoided, and 40% were not aware that some medications can affect cognition.

As We Age, We Metabolize Less Effectively

There's a reason over-medication disproportionately impacts older adults. Normal aging leads to changes in some vital organ functions. A person's lungs, kidneys and liver, for example, don't work as efficiently with age. This means that an older person's body metabolizes medication less effectively, putting them at greater risk for side effects.

The more medications you are taking, the higher the risk of those drugs interacting dangerously with each other. Multiple medications can cause confusion, lightheadedness and even internal bleeding — all dangerous and injurious conditions. Here are 10 medications that the American Geriatrics Society (AGS) says older adults should avoid or use with caution. Of course, every individual is different, so talk to your health care provider or pharmacist before stopping any medications.


Fortunately, a national movement of hospitals and health systems is tackling the medication overload problem. The John A. Hartford Foundation and the Institute for Healthcare Improvement's Age-Friendly Health Systems initiative focuses on older patients' medications as one element of a 4Ms framework that guides care. (The three other "Ms" are: focusing on what matters to older patients, promoting healthy mentation and improving mobility.)

Health systems participating in the initiative are not only addressing medication risks, but also working to ensure that medications don't interfere with quality of life. For example, by asking about what matters most to an older patient, a doctor, physician assistant or nurse practitioner may recommend de-prescribing or changing a blood pressure medication that is making a patient too lightheaded to play with her young grandchildren.

Speaking Up

When it comes to using medications safely and ensuring they don't negatively impact your quality of life, speaking up is the most important thing you can do. Unfortunately, three in four older adults aren't aware that they have the right to ask for, and receive, health care tailored to what they need and want. Medications can impair quality of life and that should always be questioned.

Thanks to organizations like the Lown Institute and AGS, raising your medication concerns should be a normal and key part of any health care visit. The National Institute on Aging also provides a helpful worksheet that you can fill in and bring to your next appointment. Advanced preparation will help you get your questions answered and the care you want and need.

The next time a drug commercial interrupts your evening routine, mute your television, or better yet, turn it off and use the opportunity to jot down a list of concerns you have about your own medication regimen. Despite what the ads promise, talking to your doctor about your health care goals, what matters to you and the concerns you have about your medications will do much to ensure you're living your best life possible.

Terry Fulmer, PhD, RN, FAAN
Terry Fulmer, PhD, RN, FAAN, a Next Avenue Influencer in Aging, is President of The John A. Hartford Foundation in New York City, a national philanthropy dedicated to improving the care of older adults. Dr. Fulmer is nationally and internationally recognized as a leading expert in geriatrics and the topic of elder abuse and neglect, and her vision is catalyzing the Age-Friendly Health Systems social movement. Read More
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