overmedication

Overmedication is the administration of more medications or higher doses than are clinically warranted, leading to unnecessary exposure to drug effects and harm. It commonly arises in the context of polypharmacy, when an individual takes multiple medicines, often for several chronic conditions.

Causes include aging and comorbidity with multiple prescribers, prescribing cascades where a drug is added to treat a side effect of another medication, inadequate medication reconciliation, and insufficient deprescribing. Patient expectations, time constraints in consultations, and fragmented care also contribute.

Consequences include adverse drug events, drug interactions, cognitive impairment, falls, delirium, hospitalizations, and higher healthcare costs. In older adults, overmedication is linked to reduced functional status and frailty. Overuse of antibiotics can contribute to resistance and microbiome disruption.

Common examples are long-term benzodiazepines or antipsychotics used for behavioral symptoms in dementia, ongoing proton pump inhibitors beyond recommended durations, and multiple sedating or analgesic drugs. Deprescribing and dose optimization are important components of management.

Prevention and management involve regular medication reviews, structured medication reconciliation at care transitions, adherence to guidelines, and the use of tools such as Beers Criteria or STOPP/START to identify potentially inappropriate medicines. Pharmacist involvement, clinical decision support, and patient education support safer prescribing.