Many of America's seniors have overstuffed pillboxes—which may be doing them harm along with good. A Wall Street Journal analysis of Medicare data finds that of the 46 million seniors enrolled in Medicare's drug benefit, about 7.6 million of them had prescriptions for at least eight medications at the same time for 90 days or more in 2022. Nearly 4 million were prescribed 10 or more drugs; for more than 419,000, that number was 15. Many of those medications fall into categories geriatric experts say seniors should generally steer clear of.
The American Geriatrics Society's Beers Criteria list drugs that pose particular risks for older adults, especially when combined. Among seniors prescribed eight or more medications, 3.6 million had at least one such drug; 1.6 million were given benzodiazepines, 568,000 got gabapentin or similar sedating drugs, and more than 310,000 took muscle relaxants, which the guidelines also flag. About 147,000 patients were on all three types at once, a mix that can heighten confusion and falls. The Journal zeroes in on 83-year-old Barbara Schmidt, who had prescriptions from at least five providers and cycled through several of these, including diazepam (Valium), hydroxyzine, methocarbamol, and gabapentin—while repeatedly falling.
Experts say fragmented care is a major problem: seniors often see multiple doctors who may not share records, and patients don't always report every prescription. Medicare requires "medication therapy management" reviews, but only for a limited group of enrollees, and the Journal found those reviews didn't significantly reduce the average number of drugs taken. In Schmidt's case, it took a specialized geriatric visit in 2023 for a team to flag three sedating medications as likely culprits in her confusion and falls. After sharply cutting back, she says, the falls ceased. (Read the full article here.)
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