Which strategy best minimizes polypharmacy risk in older adults?

• A. Prescribing additional redundant medications for each condition.
• B. Regular medication reconciliation.
• C. Avoiding pharmacist involvement.
• D. Discontinuing all nonessential therapies.

Answer: (B)

Regular medication reconciliation is the best strategy because it systematically captures every medication a patient uses—including prescriptions, over-the-counter drugs, and supplements—and compares that list with current diagnoses, lab results, and organ function. This process helps identify duplications, drug–drug interactions, and dosing issues, which are common sources of adverse events in older adults who often have multiple chronic conditions and changing pharmacokinetics. By aligning each medication with current goals of care and deprescribing where appropriate, reconciliation reduces unnecessary meds, simplifies regimens, and improves safety during transitions of care. The other options either add to the problem by introducing redundant medications, remove essential safety expertise by excluding pharmacists, or apply a blunt approach that could deprive patients of beneficial therapies; deprescribing should be intentional and individualized.