The Lown Institute has released a report titled “Eliminating Medication Overload: A National Action Plan,” developed by a group of 22 experts in medication use, including patient advocates, physicians, nurses, pharmacists, and researchers from the United States and Canada. ACCP members Kristin Zimmerman and John Devlin served on the report’s Working Group and Advisory Committee, respectively. Support for the report was provided by the Gordon and Betty Moore Foundation.

“A lot of attention is currently focused on the cost of medications,” says Shannon Brownlee, senior vice president of the Lown Institute and coauthor of an earlier report, Medication Overload: America’s Other Drug Problem, which laid out the scope of medication-related harm:

The most costly medications are those that are not needed, or are causing harm. Over the next decade, the United States is on track to spend $62 billion on unnecessary hospitalizations caused by too many medications. More importantly, medication harm will lead to the premature death of more than 150,000 older Americans.

Eliminating Medication Overload recommends five high-level action areas:

1. Implement prescription checkups: Patients using multiple medications need regular prescription checkups – visits where they review all of their medications with their primary care provider and identify unnecessary or potentially harmful medications that can safely be deprescribed (discontinued or reduced in dose).
2. Raise awareness about medication overload among clinicians, policy-makers, and the public: The American health care system and the public have been lulled into thinking there is “a pill for every ill.” The scope and severity of the problem of medication overload is invisible to health care professionals and policy-makers, the very stakeholders who must ensure patient safety. Targeted campaigns as well as larger, mass appeal efforts to raise awareness would encourage patients to “ask their doctors” if medications are wrong for them.
3. Improve information at the point of care: Health care providers have no clear, accurate, up-to-date information on the harms and benefits of medications when making prescribing decisions, nor do they necessarily have a full list of the medications their patients are taking. Improving clinical guidelines and electronic health records are two essential actions.
4. Educate and train health professionals to reduce medication overload: Health care professionals are reluctant to deprescribe because they have insufficient training in this area. In professional schools and continuing education, curricula must be adapted to an older population, with greater emphasis on the potential harm of medication for older adults.
5. Reduce industry influence

The Lown Institute is a nonpartisan think tank dedicated to transforming America’s high-cost, low-value health system. The institute conducts research, generates bold ideas, and creates a vision for a just and caring system of health that works for all.