September and October 2024
Polypharmacy and the use of multiple high-risk medications in older adults with multiple coexisting chronic conditions is a growing concern.
To target potentially dangerous combinations of medications, the Centers for Medicare and Medicaid Services (CMS) is adding two medication-related performance measures in 2025 (2027 Star Ratings):
- Polypharmacy Use of Multiple Anticholinergic (ACH) Medications in Older Adults
- Percentage of adults (≥ 65 years old) with concurrent use of ≥ 2 unique anticholinergic medications
- Concurrent Use of Opioids and Benzodiazepines
- Percentage of adults (≥ 18 years old) with concurrent use of prescription opioids and benzodiazepines
Strategies for Improving Medication Use:
- Educate patients about the potential risks of concurrent therapies (e.g., increased fall risk, respiratory depression)
- Assess medications for appropriate indication and duration at each visit and discontinue any non-essential medications
- Offer safer, non-pharmacological alternatives (e.g., cognitive behavioral therapy, physical therapy)
- If concurrent therapy is medically necessary, limit medication use to the shortest duration (<30 days) at the lowest effective dose
For a comprehensive list of potentially inappropriate medications in older adults, please refer to the 2023 American Geriatrics Society Beers Criteria. For all other inquiries, please email us.