Some of the latest research estimates that 67 percent of geriatric patients take five medications or more. Millions of patients are stuck in the polypharmacy rut. While many medications are necessary and life-saving, I’ve made it my life’s work (15+ years) to try to optimize and ideally reduce the number of medications that patients are taking. I have a deep appreciation for how adding more medication can lead to frustrated patients, worse outcomes, adverse effects, drug interactions, more frequent clinic visits, and hospitalizations.

New medications can unknowingly cause adverse effects that prompt new diagnoses and new prescriptions to manage those adverse effects. What the patient is left with is a vicious cycle called the prescribing cascade that leads to more medication, worsening health, and a feeling of helplessness that they will be taking several medications for the rest of their life.

I designed this book to help healthcare professionals identify the prescribing cascade and the collateral damage that can result on account of polypharmacy. Throughout the book, I provide countless case examples of common adverse effects, the prescribing cascade, and complications resulting from polypharmacy. I have included examples of over 200 of the most commonly prescribed medications.

Ultimately, this book will help you recognize polypharmacy, the prescribing cascade, and more importantly, give you actionable situations, case scenarios, and ideas to help reduce medications in your patients.