Low-value Care

Prevalence of Central Nervous System–Active Polypharmacy Among Older Adults With Dementia in the US

Abstract: This pharmacoepidemiology study uses Medicare claims data to describe the prevalence of central nervous system–active polypharmacy among community-dwelling older adults with dementia in the US, including durations of exposure and number of drugs and drug classes.

Publication: JAMA

Date Published: March 9, 2021

Author(s): Donovan T. Maust, MD, MS; Julie Strominger, MS; H. Myra Kim, ScD; Kenneth M. Langa, MD, PhD; Julie P. W. Bynum, MD, MPH; Chiang-Hua Chang, PhD; Helen C. Kales, MD; Kara Zivin, PhD; Erica Solway, PhD, MSW, MPH and Steven C. Marcus, PhD

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To eliminate medication overload, serious cultural, educational, and policy changes are needed. This action plan offers recommendations for policymakers, health care institutions, clinicians, and patients across five key categories to reduce harm from multiple medication use. Suggested Citation: Eliminating medication overload: A national action plan. Working Group on Medication Overload. Brookline, MA: The Lown Institute, 2020. DOI: https://doi.org/10.46241/LI.YLBW4885

Pharmaceutical marketing is a significant factor in the growing public health crisis of medication overload, which puts millions of older adults at risk of preventable harm and premature death. This issue brief provides recommendations to reduce pharmaceutical industry influence by limiting pharma sales rep visits to clinicians and direct-to-consumer advertising.

This issue brief provides recommendations for clinical practice guidelines and electronic health records that would give clinicians the information they need to appropriately prescribe and deprescribe.