Deprescribing in Health Care: Why Less Medication Can Be More

Key Takeaways

• 70% adults 40-79 use prescription meds; 20% use five+.
• Polypharmacy raises falls, cognitive decline, ER visits.
• Deprescribing stops unnecessary, harmful drugs with physician oversight.
• Lifestyle changes crucial for health beyond medication.
• Insurers, EHRs, coordination needed for systematic deprescribing.

Summary

The American Medical Association is urging clinicians to adopt deprescribing—systematically reviewing and stopping medications that no longer benefit patients. Nearly 70% of adults aged 40‑79 fill a prescription each month, and over 20% take five or more drugs, driving falls, cognitive decline, and costly ER visits. Deprescribing emphasizes evidence‑based, patient‑centered care and integrates lifestyle interventions such as nutrition and exercise. The AMA calls for insurer reimbursement, coordinated care, and EHR enhancements to make medication reviews routine.

Pulse Analysis

Polypharmacy has become a silent epidemic in the United States, especially among older adults managing multiple chronic conditions. CDC data show that a sizable portion of the population regularly fills prescriptions, with a fifth juggling five or more drugs. Each additional medication compounds the risk of drug‑drug interactions, falls, and cognitive impairment, translating into tens of thousands of emergency‑room visits annually. These trends strain hospital resources and inflate health‑care costs, prompting policymakers and clinicians to seek more sustainable prescribing practices.

Deprescribing offers a structured, evidence‑based approach to mitigate these risks. By conducting comprehensive medication reviews, physicians can identify drugs that are redundant, outdated, or harmful, and safely taper or discontinue them. Studies demonstrate that targeted deprescribing reduces adverse events, improves functional status, and often aligns treatment with patients’ evolving health goals. Crucially, the process encourages open dialogue about lifestyle factors—nutrition, activity, sleep, stress management—that can replace or complement pharmacotherapy, fostering a more holistic model of care.

Realizing deprescribing at scale requires systemic support. Payers must reimburse clinicians for the time-intensive medication reconciliation, while electronic health‑record platforms need interoperable tools to flag potential redundancies and capture over‑the‑counter supplements. Cross‑specialty coordination ensures that changes made by one provider are communicated across the care continuum, preventing inadvertent re‑prescribing. As the AMA champions these reforms, the health‑care ecosystem stands to gain lower hospitalization rates, reduced drug expenditures, and a shift toward preventive, patient‑centered medicine.