Is “Deprescribing” Right for You?

So it’s no wonder that more people are interested in “deprescribing.” Deprescribing is just a fancy term that means taking fewer medications.

The University of Michigan National Poll on Healthy Aging surveyed 2,563 adults age 50 to 80 and found that 80% of respondents said they would be open to stopping one or more long-term prescriptions if a provider said it was possible.

Part of the reason people do not question taking multiple medications is that we assume our providers are reviewing our medications more than they actually are. This can be an especially pronounced problem for people who see more than one medical provider.

“While we found that over 90% of older adults who take at least one prescription medicine expect their provider to review their list of medicines at least annually, research has shown this is often not the case,” said Sarah Vordenberg, a professor who worked on the poll. “This drives home the importance of comprehensive medication reviews, which can often be billed to insurance by clinics and pharmacies as a separate patient encounter.”

The best plan is for older adults and their caregivers to be proactive about managing medications and asking healthcare providers questions. Here are some tips for doing that.

Keep one complete list. Write down everything you take: prescriptions, over-the-counter products, vitamins, and supplements. Deprescribing can apply to all of these, and 38% of poll respondents regularly take three or more vitamins, minerals, or supplements.

Ask about a comprehensive medication review. Medicare and other insurance plans may cover a thorough review by a pharmacist or other provider. Only 24% of eligible adults in an earlier poll had received one, and most who hadn’t were unaware their insurance might cover it. More than 90% of older adults expect their provider to review their medicine list at least once a year, but research shows this often doesn’t happen.

Never stop a medication on your own. If you’re wondering whether you still need something, bring it up with your care team first. They can tell you whether stopping is safe and whether the dose should be lowered gradually.

Be upfront about cost. Among older adults with health or disability issues that limit daily activities, 15% said cost drove them to stop a medication. That’s twice the rate of those without such limitations. If you’re skipping doses or splitting pills to save money, say so. There may be cheaper options.

Bring someone along. Susan Reinhard of the AARP Public Policy Institute notes that research shows improved outcomes when family members help with deprescribing decisions. A family member or caregiver can take notes and help you follow through.

Good medication management is a partnership. Come prepared, ask openly, and keep your care team in the loop