Polypharmacy: Addressing Medication Overload in Older Adults with Connected Care

Older adults are being prescribed more medications than ever before. In the United States, research shows that more than 40% of adults aged 65 and older now take five or more prescription drugs every day, a number that’s roughly tripled since 2000. Similar patterns have been observed globally, as aging populations and chronic conditions have made long-term medication use more common (Jama Network).

This growing trend, known as polypharmacy, usually develops gradually. One prescription is added for blood pressure, another for sleep, another to manage side effects, and over time, the list grows. What starts as appropriate treatment can become medication overload, a situation that research suggests may increase the risk of side effects and interactions that complicate care. 

Polypharmacy is an operational issue as much as it is a medical one. Studies indicate that medication-related complications contribute to preventable emergency visits and hospitalizations among older adults. These events often stem from fragmented communication, limited medication review, or delays in updating medication records. The good news is that improving data visibility and coordination can make medication management simpler, safer, and more proactive (Lown Institute). This is something that Health Impact Alliance (HIA) is working to achieve through its connected care solutions. 

Understanding Polypharmacy in Practice

Polypharmacy is commonly defined as the use of five or more medications. But as research points out, the problem isn’t the number of medications someone is taking; it’s the overlap of multiple. Older adults often metabolize medications differently than younger patients, which can make them more sensitive to certain drug combinations or doses that were previously well-tolerated (PubMed). 

Some medications, such as sedatives or those with anticholinergic properties, have been linked to slower reaction times, reduced balance, and cognitive changes. When several of these drugs are used together, their effects can add up, impacting day-to-day functioning and overall hxealth (PubMed).

For patients, the challenges are often subtle but significant. Many report fatigue or confusion that may go unnoticed or be mistaken for ageing. Families struggle to keep track of refill dates and medication instructions, while clinicians, often working across specialties, must reconcile long lists without a single shared source of truth. Even well-coordinated care teams can find it difficult to maintain consistency when medication data is fragmented across systems (PubMed).

Why Polypharmacy Persists

If the risks are known, why does polypharmacy remain so common? Several system-wide factors contribute:

Fragmented care delivery: Older adults often see multiple specialists, for example, a cardiologist, an endocrinologist, and a neurologist, each focused on a specific condition. Without connected records, it’s hard to identify duplicate prescriptions or potential interactions.

A culture of adding, not reviewing: Healthcare systems are built to start new treatments, not always to reassess old ones. Research describes this as the “prescribing cascade,” where side effects from one medication lead to new prescriptions intended to address them.

Complexity at home: Medication schedules can be hard to follow. Small print, similar pill appearances, and differing instructions can lead to skipped doses or unintentional repeats. Over time, even minor errors can add up.

In short, the healthcare system was designed to treat conditions individually, not manage the interactions between them. Solving this requires infrastructure that enables shared data, regular review, and clear communication between clinicians, caregivers, and patients (Lown Institute).

A Global Challenge That Needs Smarter Systems

This issue isn’t limited to one country. Research shows similar patterns worldwide. In the U.S., the rate of polypharmacy among adults over 65 has doubled in two decades. In Europe, roughly one in three older adults takes five or more medications, with some countries reporting rates above 50%. In Brazil, studies estimate that between 13% and 33% of adults over 65 fall into this category, depending on region and healthcare access (Pharmacy Practice).

As people live longer and manage multiple chronic conditions, these numbers are expected to rise. But this doesn’t have to mean more risk. The opportunity lies in building smarter systems that help providers make informed, coordinated decisions. Polypharmacy is increasingly recognized as a modifiable risk factor for functional decline, meaning that with the right tools and oversight, it can be managed and reduced (PubMed).

Technology at a Turning Point

Digital health technology is opening new doors for safer, more connected medication management. The most promising innovations are already reshaping how care teams monitor and support patients:

Smart pill dispensers:
Automated dispensers ensure medications are taken correctly by releasing the right dose at the right time and sending alerts if a dose is missed. Research suggests these devices can improve adherence and prevent accidental double-dosing.

AI-powered medication review:
Artificial intelligence tools can quickly scan complex medication lists, identify potential interactions or duplications, and recommend safe adjustments. This allows clinicians to focus on patient discussions rather than manual checks.

Predictive analytics:
Combining medication data with metrics like movement, sleep, or activity patterns can help flag potential risks before they escalate. Early studies show that predictive tools may enable earlier interventions and more tailored care.

Telepharmacy and shared dashboards:
Connected dashboards give pharmacists, clinicians, and caregivers access to the same up-to-date medication records, reducing errors during care transitions and making reconciliation faster and more accurate.

Together, these solutions move medication management from a reactive task to a preventive strategy, improving both safety and efficiency (Heart to Heart)

HIA’s Role: Building Independence Through Connected Care

The Health Impact Alliance (HIA) is helping reimagine how medication management fits into connected care. Through its LifelineConnect ecosystem, HIA is exploring the integration of smarter medication organization tools, caregiver dashboards, and clinical decision support into a single, secure platform.

Instead of relying on manual reminders and siloed processes, our approach looks toward a future where medication routines can be automatically tracked, where authorized caregivers receive timely updates when support is needed, and where clinicians can review adherence trends from a unified view.

By connecting medication data more seamlessly with pharmacy systems and electronic health records (EHRs), our goal is to support greater clarity across providers. Accessibility remains central,  including flexible text display, high contrast options, and multilingual support.

This direction reflects our broader aim: shifting toward proactive, digitally supported prevention rather than reactionary care.

The Future: Preventing Decline Before It Starts

The next stage of healthcare is integration. Medication data will increasingly connect with other health indicators like mobility, sleep, and cognitive patterns to create a more complete understanding of patient well-being.

If a new prescription coincides with changes in activity or rest, analytics can highlight it for review. If cognitive data shifts alongside an increase in sedative medication, the system can prompt the care team to reassess. Research suggests these data connections can help detect risks earlier and support personalized interventions.

Prevention in this context doesn’t mean fewer treatment options; it means making safe, data-informed care the standard. When clinicians, caregivers, and patients share the same information, decision-making becomes more consistent, and confidence in care increases.

Polypharmacy may always be part of modern medicine, but its risks can be managed more effectively. The technology already exists. The next step is implementation of connected devices, data, and care teams across the continuum.

That’s the foundation of HIA’s Connected Care ecosystem: using technology to simplify medication management, close communication gaps, and create safer, more coordinated care for aging populations.

Partnering for Safer Care

HIA collaborates with healthcare organizations, payers, and senior-care networks to integrate smart dispensing, telepharmacy, and analytics solutions into everyday workflows. These partnerships help transform medication management from a manual process into a connected, data-informed system that flags risks like missed doses or harmful interactions before they lead to decline.

By linking insights across pharmacies, clinicians, and families, HIA builds a continuous circle of safety and independence, reducing preventable hospitalizations and easing caregiver strain, turning medication safety into a measurable driver of better aging outcomes.

Stay Connected with HIA

If your business is interested in working with the HIA on Dementia or Precision Cohort analysis of any kind, then contact us at partner@healthimpactalliance.com with a brief outline of your proposal.

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