On the one hand, every year we are fortunate to have new medications that help older adults and people living with serious illness.  New treatments for lung cancer with remarkable survival outcomes come to mind, for example.   On the other hand, the tremendous growth in medications has led to an explosion of prescribing, polypharmacy, with attendant side effects and harms.   In this week's podcast, we talk with Nagham Ailabouni, a pharmacist and researcher joining us from Australia (song choice: Down Under!) about her review of major articles on medication safety and quality for older adults.  Dr. Ailabouni summarized the top four hardest hitting in a recent publication in the Journal of the American Geriatrics Society, or JAGS.  The four articles are: Older Medicare Beneficiaries Frequently Continue Medications with Limited Benefit Following Hospice Admission Prescribing of oral anticoagulants in the emergency department and subsequent long-term use by older adults with atrial fibrillation Effect of an Electronic Medication Reconciliation Intervention on Adverse Drug Events: A Cluster Randomized Trial Intensification of older adults' outpatient blood pressure treatment at hospital discharge: national retrospective cohort study Dr. Ailabouni’s pet peeve medication she sees prescribed to hospice patients?  High dose metformin.  Listen to the podcast for more! -@AlexSmithMD