Do not prescribe medications for patients on five or more medications, or continue medications indefinitely, without a comprehensive review of their existing medications, including over-the-counter medications and dietary supplements, to determine whether any of the medications or supplements should or can be discontinued.

Rationale and Comments

Studies have shown that patients taking five or more medications often find it difficult to understand and adhere to complex medication regimens. A comprehensive review, including medical conditions, should be done at periodic intervals, at least annually, to determine if the medications are still needed and if any medications can be discontinued.

Sponsoring Organizations

American Society of Health-System Pharmacists

Sources

Expert consensus

Disciplines

Geriatric Medicine

References

Maher RL, et al. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014; 13: 57-65. dx.doi.org/10.1517/14740338.2013.827660.
Gorard, DA. Escalating polypharmacy. QJM 2006; 99 (11): 797-800. doi.org/10.1093/qjmed/hcl109.
Lehnbom, EC, et al. Impact of medication reconciliation and review on clinical outcomes. Ann Pharmacother. 2014;48:1298-1312.
Shane, R and Abramowitz, PW. Choosing Wisely: Pharmacy’s role in effective use of medications. Am J Health-Syst Pharm. 2015; 72:1529-30. doi.org/10.2146/ajhp150324.