Mix of medications may spark unwanted side effects

Many older Americans take a variety of prescription drugs, yet new research suggests that combining various medications is not always wise.

Taking lots of different drugs for different conditions is called “polypharmacy,” and a team of researchers set out to find how doctors take this into account in their prescribing. To address this, providers discuss “deprescribing” — working with patients to cut down on unnecessary or redundant medications.

To look at prescribing habits, researchers led by Dr. Parag Goyal from Weill Cornell Medicine in New York City and Dr. Timothy Anderson from Beth Israel Deaconess Medical Center in Boston, quizzed 750 geriatricians, general internists and cardiologists. They got responses from 12% to 26% of these doctors.

Over 80% of the doctors who responded said that they recently considered not prescribing a cardiovascular medication and cited adverse side effects as the most common reason.

Often doctors are reluctant to halt a drug another doctor has prescribed for fear of stepping on a colleague’s turf.

Among geriatricians, 73% said they might discontinue a drug that was not expected to help patients who had a short time to live, compared with 37% of general internists and 14% of cardiologists.

Also, 26% of geriatricians said that they might stop prescribing drugs that affect the ability to think and make decisions, compared with 13% of general internists and 9% of cardiologists.

The report was published in November in the Journal of the American Geriatrics Society.

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