When Less is More
Medications are often the frontline in managing chronic illness, easing symptoms, and improving quality of life—especially as we age. But what happens when those same medications begin to do more harm than good?
For many older adults, the medicine cabinet begins to fill up. Over time, medications that once served a valid purpose may become risky as we age. Taking so many pills becomes burdensome, side effects and/or drug interactions can impact a person’s well-being, and this can especially be so when facing an end-of-life health condition.
That’s where deprescribing comes in.
What Is Deprescribing?
For elderly patients, particularly those in palliative care or receiving hospice services, deprescribing is a planned process of reducing or stopping medications that may no longer be helpful—or may even be harmful.
The goal is to reduce medication burden, minimize side effects, and improve quality of life.
By eliminating unnecessary medications, patients may feel better and eat better. Instead of filling the stomach with drugs, skipping a pill that no longer serves a purpose could mean less nausea and more room in the stomach for actual nutrition.
A study published in JAMA Internal Medicine indicated that over 90% of patients are willing to stop a medication if their doctor says it’s okay.
The BEERS Criteria
In 1991, geriatrician Dr. Mark H. Beers created the BEERS Criteria—a list of potentially inappropriate medications for older adults. Since that time, it has become a critical tool for healthcare professionals to weigh the risks and benefits of medications in aging patients.
The takeaway is this––deprescribing isn’t about denying someone their medication––it’s about meaningful, individualized care that prioritizes a patient’s current needs and goals.
Why It Still Matters Today
Despite decades of deprescribing efforts, polypharmacy—the use of multiple medications—remains a significant issue among older adults. On average, adults aged 65 and older take 4.6 medications per month, and nearly 1 in 5 take 10 or more. For someone managing a complex health condition, that many meds is a heavy load.
5 Commonly Deprescribed Medications
Here’s a list of common medications more likely to be flagged for deprescribing:
- Proton Pump Inhibitors (PPIs) – often used for heartburn or reflux, but long-term use can lead to complications.
- Statins – used to lower cholesterol but may not offer much benefit in older patients with limited life expectancy.
- Antibiotics – especially when used unnecessarily or in end-of-life care.
- Antimuscarinics – commonly prescribed for overactive bladder but can cause confusion or constipation in the elderly.
- Benzodiazepines and “Z” drugs – used for anxiety and sleep, but often linked to falls, confusion, and dependency.
Takeaway: Review Medications Regularly
If you or a loved one are managing multiple prescriptions, talk to your healthcare provider or hospice nurse. Review your medications—prescription and over the counter—at least once a year. And NEVER stop a medication without first seeking professional guidance.
Deprescribing can and should be viewed as part of ongoing care, allowing patients and caregivers to coordinate treatment with personal goals and enhance quality of life.