Over 82% of Americans aged between 50 and 80 regularly take prescription medications, and a significant 80% of these individuals are open to discontinuing one or more of these drugs if their healthcare providers agree, according to a new study from the University of Michigan. The research, however, highlights the complexities involved in such decisions. The study’s authors advocate for health care professionals, including prescribers and pharmacists, to engage deeply with older adults to determine whether reducing medication—commonly referred to as “deprescribing”—is appropriate based on individual circumstances.
The research in the Journal of General Internal Medicine draws on data from the University of Michigan’s National Poll on Healthy Aging. This recent study expands on a report from April 2023, focusing mainly on individuals who use medication to manage cardiovascular diseases or diabetes. About 30% of these individuals expressed a strong interest in deprescribing, primarily because the medicines they use target asymptomatic conditions like high blood pressure, cholesterol, and blood sugar—critical factors in preventing severe health crises if unmanaged.
Despite these medications’ essential role in preventing future health problems, the lack of immediate benefits can lead patients to question their necessity. On the other hand, the study found that those suffering from conditions with immediate symptoms, such as arthritis, mental health issues, and respiratory disorders, were less inclined to stop their medications. This suggests a clear preference for continuing treatments that directly relieve distressing symptoms.
Sarah Vordenberg, Pharm.D., M.P.H., the study’s lead author and a clinical associate professor at the U-M College of Pharmacy, emphasizes the importance of comprehensive medication reviews. These reviews are critical as they assess all medications and supplements a person is taking, aiming to safely reduce dosages, costs, and frequency of intake. While Medicare covers such reviews for eligible enrollees, uptake is surprisingly low, as shown by data from a 2020 National Poll on Healthy Aging report.
The study further explores the specific conditions reported by poll respondents, revealing varying degrees of openness to deprescribing: 84% of those on prescription drugs have a cardiovascular condition, with 35% open to stopping at least one medication; 29% have diabetes, with 30% considering deprescribing; nearly half report having arthritis, but only 17% would consider stopping such medications; 22% have brain-related conditions affecting mental health or cognition, with 19% open to deprescribing; and 11% taking medication for lung diseases like asthma or chronic obstructive pulmonary disease, with a similar percentage open to stopping treatment.
Jeffrey Kullgren, M.D., M.P.H., M.S., an associate professor of internal medicine at Michigan Medicine and a researcher at the VA Ann Arbor Healthcare System, comments on the changing guidelines for the use of cardiovascular and diabetes medications and emphasizes the need for ongoing, tailored discussions between patients and providers. The rise of direct-to-consumer services, particularly for medicines like GLP-1 inhibitors, highlights the critical need for healthcare providers to be fully informed about all substances their patients use, regardless of the source. This approach ensures that treatment decisions best suit individual health needs and circumstances.
More information: Sarah E. Vordenberg et al, Interest in Medication Deprescribing Among US Adults Aged 50–80, Journal of General Internal Medicine. DOI: 10.1007/s11606-024-08945-x
Journal information: Journal of General Internal Medicine Provided by Michigan Medicine – University of Michigan
