As Americans age and chronic conditions become more prevalent, many find themselves managing a growing list of medications. Now, the American Medical Association (AMA) is advocating for a shift in how physicians and patients approach these complex medication regimens, urging a practice known as “deprescribing.” This involves a careful and supervised review of all medications – both prescribed and over-the-counter – to determine if the benefits continue to outweigh the risks.
The demand for this reevaluation is significant. According to data from the National Center for Health Statistics (NCHS), more than 20% of U.S. Adults are taking five or more prescription medications each month, a condition defined as polypharmacy. This trend is particularly pronounced in older adults, with over one-third of those aged 60-79 using five or more drugs concurrently, according to the NCHS data brief. The AMA believes a proactive approach to medication review is crucial for optimizing patient health and well-being.
What is Deprescribing?
Deprescribing isn’t about abruptly stopping medications or denying necessary care. Instead, it’s a planned and collaborative process between a physician and patient to safely reduce or discontinue medications that may no longer be beneficial, or may even be causing harm. As AMA CEO and Executive Vice President John J. Whyte, MD, MPH, explained in a recent op-ed, there are several reasons why a medication might need to be reevaluated. A patient’s condition may have improved, newer treatments may be available, or interactions with over-the-counter drugs or supplements could be occurring.
The potential consequences of polypharmacy are substantial. For patients with multiple health conditions, each additional medication can increase the risk of falls, cognitive decline, and adverse events, leading to tens of thousands of emergency room visits and hospitalizations annually. Deprescribing aims to mitigate these risks by ensuring that every medication prescribed remains necessary, evidence-based, and aligned with the patient’s current health goals.
The Importance of Open Communication
The AMA emphasizes the importance of open communication between doctors and patients. Dr. Whyte encourages patients to bring a complete list of all medications and therapies – including those purchased over-the-counter and any supplements – to each appointment. This allows physicians to conduct a thorough assessment and provide individualized recommendations. However, this is just the first step.
“If we truly want to reverse the tide of chronic disease in America, we need to go beyond managing symptoms,” Dr. Whyte wrote. “We need to rethink the entire approach—including how many medications a person is on and why.” The AMA advocates for a broader focus on lifestyle factors – including nutrition, physical activity, sleep, stress management, and social connection – as essential components of healing and prevention.
AMA Policy and Resources
The AMA has established policies to support deprescribing efforts, including encouraging physicians to educate patients about the effects of all medications and supplements. The organization also promotes the practice of physicians initiating discussions with patients about optimizing their medication regimens, using the fewest number of drugs necessary to achieve optimal health. The AMA is working with stakeholders and electronic health record (EHR) vendors to address inaccuracies in medication reconciliation and to ensure that all medications, including nonprescription options, are included in patient records for compatibility screening.
The AMA supports education and decision-making tools to assist physician care teams evaluate medications holistically. These include AMA STEPS Forward® toolkits, which are part of the AMA Ed Hub™, offering continuing medical education (CME) modules.
“Deprescribing is not about withholding care—it’s about delivering the right care, at the right time, for the right reasons,” Dr. Whyte concludes. “At its core, this is about respect: for the science, for the art of medicine, and most importantly, for the lives of our patients.”
As the healthcare landscape evolves, the concept of deprescribing is likely to gain further momentum. Continued collaboration between physicians, patients, and healthcare technology developers will be essential to refine and implement this approach effectively, ultimately leading to safer and more personalized care. What comes next will depend on the continued development of tools and resources to support physicians in this important perform.
What are your thoughts on deprescribing? Share your experiences and perspectives in the comments below.
Disclaimer: This article provides informational content and should not be considered medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your treatment or care.
