As people age, chronic illnesses become more common — and so does the number of medications taken each day. But prescribing more drugs doesn’t necessarily mean better care. This is the premise behind the growing debate on “deprescribing,” the practice of eliminating treatments that are no longer necessary or that may even be harmful.
At least two chronic conditions affect 75% of people over 65, and nearly all those over 80. This often leads to so-called polypharmacy — defined as taking five or more medications — which becomes excessive when the number reaches ten or more.
Among those over 80, the average number of medications taken is 7.4, with particularly high figures recorded in nursing homes and assisted-living facilities. The risk is that this increases drug interactions, side effects, and complications that can even lead to hospitalization.
This is where deprescribing comes in — a process aimed at reviewing therapies and assessing which medications are genuinely beneficial for each individual patient. Family doctors play a central role, coordinating specialists’ prescriptions and taking into account the overall health of the elderly patient.
As Carlo Renzini, president of the ASGG (Associazione Sammarinese di Gerontologia e Geriatria), explains: “Deprescribing doesn’t mean cutting medications at all costs, but optimizing pharmacological treatment through a multidimensional assessment of the patient — an approach that involves the patient, doctors, and caregivers, especially when dealing with elderly patients.”
Alongside medication, it remains essential to consider diet, physical activity, sleep quality, and social relationships, while avoiding unnecessary treatments and paying close attention to the unsupervised use of supplements and over-the-counter products.
The topic will be explored in depth on November 13 and 14, during the ninth module of the “Giancarlo Ghironzi” Master’s program in Geriatric Medicine. Speakers will include Graziano Onder from Rome, Vittorio Vitale from Rimini, Daniele Battelli from San Marino, Marco Fiorentino from Bari, and Stefano De Carolis.
