How to Review Medications for Safety & Appropriateness

By now you’ve probably heard that older adults are often taking “too many” medications.

You also hopefully know that older people are often prescribed medications that may be harmful, or no longer necessary.

So what can you do?

The answer is to request a careful medication review, in which all medications are reviewed for appropriateness and safety. This is part of a process called “deprescribing.’

Geriatricians are trained to do this, but if you can’t find a geriatrician, you should be able to get a decent review from the primary care doctor.

But before you go in, it pays to do a little homework on your own. That’s because the input of a patient and her caregivers is actually crucial to determining whether each medication is appropriate for her.

To help you complete this background preparation for a medication review, I’ve written this article for A Place for Mom:

5 Steps to Prepare for a Medication Review

The 5 Step Process You Can Use to Get a Better Medication Review

In the article, I explain that it’s a good idea to review an aging adult’s medications on your own, before going to see the doctor. This will free up some time when you’re actually seeing the doctor — which might mean more time for questions or discussion — and can help you spot safety issues that a non-geriatrician might otherwise not notice.

Specifically, I recommend you consider the following five steps:

  1. List all medications your older relative is taking, along with the intended purpose of each medication.
  2. If the purpose of a medication is to control a sign or symptom, take note of when the symptom was last checked on, and how it’s been doing.
  3. Check to see if any of the medications are on the Beer’s list.
  4. Check for signs of over-treatment, especially for high blood pressure and diabetes.
  5. Check for drug interactions.

For more information on how to complete these steps, including links to useful resources, read the full article at A Place for Mom.

You can also learn more about the overtreatment of hypertension and diabetes in this NY Times article: Some Older Patients Are Treated Not Wisely, but Too Much.

Last but not least: try our podcast episode on deprescribing (featuring the wonderful deprescribing expert Dr. Cara Tannenbaum), plus we have a related article here: Deprescribing: How to Be on Less Medication for Healthier Aging.

Questions? Comments? Let me know below!