Seniors want to use less medication, but research shows caution is advised

A new study from the University of Michigan found that more than 82 percent of Americans between the ages of 50 and 80 take one or more prescription medications, and 80 percent of them say they would be willing to stop taking one or more of those medications if their health care provider gave the green light.

But it’s not that simple, say the researchers. They call on prescribers and pharmacists to talk to older people about their personal situation and determine whether a form of ‘deprescribing’ is suitable for them.

The study, published in the Journal of General Internal Medicineuses data from UM’s National Poll on Healthy Aging and builds on a poll report published in April 2023.

It shows that about 30% of older adults who are taking medications to treat heart disease or diabetes are most interested in tapering off these medications. This could be because many of these medications treat asymptomatic risk factors, such as high blood pressure, high cholesterol and high blood sugar.

If these risk factors are not controlled, they can set the stage for future emergencies and crises. Medications to treat these conditions are therefore important preventive tools.

However, older people do not always immediately notice the benefit of these medications, which may make them wonder whether they still need them.

In contrast, the study found that older adults who were prescribed medications for conditions that were already causing symptoms, such as arthritis pain, mental health conditions and breathing problems, were less interested in stopping those medications.

The new research underscores the importance of comprehensive drug reviews, says Sarah Vordenberg, Pharm.D., MPH, lead author of the study and clinical associate professor in the U-M College of Pharmacy.

During these appointments, all medications and supplements that a person is taking are reviewed. Options are also considered to safely reduce the dosage, cost and number of times a person has to take medications per day.

Medicare pays for such appointments for those with eligibility. But the number of older adults taking advantage of the option, even among those who qualify, is growing, according to data from a 2020 report by the National Poll on Healthy Aging.

Condition specific preferences

The new research goes beyond the 2023 report on deprescribing by delving deeper into the conditions respondents reported having.

• Of those taking at least one prescription drug, 84% reported having some form of cardiovascular disease, including high blood pressure. Of this group, 35% were open to the possibility of stopping at least one of their cardiovascular medications.
• Of the respondents who took at least one medication, 29% reported having diabetes. Of this group, 30% were open to the possibility of stopping one of their diabetes medications.
• Nearly 50% of respondents taking prescription medications reported suffering from arthritis. However, only 17% of this group were open to stopping the medication for that condition.
• 22% of people taking prescription drugs reported having a brain disorder that affected their mental health or cognition. 19% of them were open to a solution to stop taking the medication they were taking for that.
• 11% of prescription drug users said they had a lung condition, such as asthma or chronic obstructive pulmonary disease. Of those, 11% said they would be open to stopping a medication they were taking for it.

“As guidelines for the use of medications that reduce cardiovascular risk change as we learn more about who benefits most from them, it is important for patients and healthcare providers to talk openly and regularly about what is best for their individual circumstances,” said Jeffrey Kullgren, MD, MPH, MS, associate professor of internal medicine at Michigan Medicine and a physician and researcher at the VA Ann Arbor Healthcare System.

“The same goes for diabetes-related medications, especially with the rise of direct-to-consumer services, including GLP-1 inhibitor medications,” he added. “And with any prescription medication or supplement for any condition, it’s critical that your healthcare providers know everything you’re taking, regardless of how you get it.”