Listen: Shannon Brownlee and Judith Garber on the Agewyz Podcast

By Judith Garber | April 11, 2019

The Lown Institute recently published the report Medication Overload: America’s Other Drug Problem, which highlights the significant harm to older adults from taking too many medications. The report finds that over the next decade, there will be 74 million outpatient visits and 4.6 million hospitalizations of older Americans due to adverse drug events. There are a myriad of factors that drive overprescribing, including disease-specific guidelines, industry influence, lack of communication, and the belief that there is a “pill for every ill.”

What can patients, families, and caregivers do to prevent harm from too many medications, when there are so many forces pushing to treat everything with drugs? Report authors Shannon Brownlee and Judith Garber went on the AgeWyz Podcast, hosted by author, media expert, and caregiver Jana Panarites, to discuss why medication overload is a problem and the important role of patients and caregivers in reducing harm from overprescribing.

On the podcast, Jana, Shannon, and Judith talk about their own experiences with managing medication overload with their parents and the questions patients and families should be asking about medications before they take new ones.

Brownlee’s mother was almost put on several new drugs by a specialist in the hospital, until they sought a second opinion with her primary care doctor, who deemed the new meds unnecessary. “Without me knowing a fair amount about polypharmacy and medication overload, and my brother being vigilant and willing to question these prescriptions, my mom would have been on a bunch of new drugs,” said Brownlee. For families and caregivers, “being aware of rapid changes in cognitive ability and memory and mood are very important for identifying a possible drug side effect,” said Garber.

Bringing a full list of medications to doctor’s visits is also extremely helpful, since the doctor may not know all of the medications the patient is taking. “I’ve seen the shock that on physician faces when I’ve gone to medical appointments with my mother with an actual list in hand of what she’s taking,” said Panarites.

Another way patients and families can prevent adverse events is avoiding unnecessary medications in the first place. Often clinical guidelines don’t tell doctors when a drug should be stopped, so there is no “stop plan” when another drug is added. “If the doctor is prescribing something for you, and you’re already on many medications, it’s important to ask ‘When will we know when the drug is working? And when will we know when it’s time to stop the medication?’ That’s something that the clinician might not be thinking about in the moment,” said Garber.

Other questions patients and family members can ask their doctor to avoid unnecessary medications are:

What is this medication for? What disease is it treating?
Is there evidence that this drug is effective for patients of my age and with my medical conditions?
- Out of 100 patients like me, how many are helped and how many are harmed by this medication?
How will we know when the medication is working or not working?
Can I start on a lower dose and see if that works?
How long should I take this medication? When should I stop taking it?
Do you know how this medication might interact with other drugs I’m already taking?
Are there side effects I should watch out for if I take this medication?

Listen to the podcast below or on the Agewyz website!

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.