A medication review is a structured conversation about every medicine a person uses. It can help older adults understand what each product does, identify possible interactions, and make complicated dosing schedules easier to manage.
The review should cover more than current prescriptions. Over-the-counter medicines, vitamins, herbal products, creams, inhalers, eye drops, and occasional medicines can also affect treatment.
Medication reviews are particularly useful after a hospital stay, when a new medicine is prescribed, when several healthcare professionals are involved, or when an older adult develops new symptoms.
Why Medication Reviews Matter for Older Adults
The body may process medicines differently with age. Changes involving the kidneys, liver, body composition, and circulation can affect how long a medicine remains in the body and how strongly it works.
Older adults are also more likely to take several medicines. This can increase the chance of drug interactions, unwanted side effects, and confusion about timing.
The FDA’s medication safety guidance for older adults recommends keeping an updated list of prescriptions, nonprescription medicines, vitamins, and supplements. The list should include each product’s name, dose, and schedule.
A pharmacist can help identify concerns, but the prescribing healthcare professional generally makes decisions about stopping a prescription or changing its dose.
What to Bring to a Medication Review
Prepare a complete medication list before the appointment. Include:
Prescription medicines
Over-the-counter pain relievers, sleep aids, cold medicines, and antacids
Vitamins, minerals, and herbal supplements
Inhalers, injections, patches, creams, and eye drops
Medicines taken only when needed
Known allergies or previous drug reactions
The name of each prescribing professional
Recent medication changes or hospital discharge instructions
Record the actual way each medicine is being used, even if it differs from the label. This gives the pharmacist accurate information and creates an opportunity to resolve unclear directions safely.
If making a list is difficult, ask the pharmacy whether the original containers can be brought to the review. Do not combine different medicines in one bottle.
Questions About What Each Medicine Does
Start by confirming the purpose of every item on the list. Ask:
What condition or symptom does this medicine treat?
How can we tell whether it is working?
How long is it usually needed?
Is this medicine duplicating another product?
Does the dose still appear consistent with the current prescription?
Is regular monitoring or laboratory testing required?
An older adult may continue taking a medicine that was originally intended for short-term use. In other cases, a product may remain necessary even when its benefits are not immediately noticeable. Ask for an explanation instead of making changes independently.
Questions About Timing and Doses
Directions such as “twice daily” or “take as needed” may not provide enough detail. Useful questions include:
What time should each dose be taken?
Should it be taken with food or on an empty stomach?
Does it need to be separated from another medicine or supplement?
What should happen if a dose is missed?
What is the maximum amount that can be taken in one day?
Can the tablet be split, crushed, or mixed with food?
Are there special storage instructions?
Some extended-release or specially coated tablets should not be crushed. A pharmacist may be able to identify a liquid, smaller tablet, or other alternative when swallowing is difficult.
Ask About Interactions
Give the pharmacist the complete list and ask whether any products could interact. Interactions can involve prescription drugs, over-the-counter products, supplements, alcohol, or food.
Ask specifically:
Do any of these medicines affect one another?
Could an over-the-counter pain reliever or sleep aid cause a problem?
Are there foods or drinks that should be limited or avoided?
Is alcohol unsafe with any of these medicines?
Could any combination increase sleepiness, bleeding, or fall risk?
Does a medical condition make any product less appropriate?
Using one pharmacy when practical can make it easier to screen new prescriptions against existing pharmacy records. If several pharmacies are necessary, provide each pharmacist with the same current medication list.
Discuss Side Effects and New Symptoms
Dizziness, confusion, unusual tiredness, constipation, sleep problems, or balance changes may sometimes be related to a medicine. They can also have other causes, so they should not automatically be blamed on treatment.
Ask the pharmacist:
Which side effects are common?
Which symptoms require an urgent call to a healthcare professional?
Could this medicine affect alertness, memory, or balance?
Is it safe to drive after taking it?
Could a recently developed symptom be medication-related?
How long might a side effect last?
Write down when a symptom began and whether it appeared after a new medicine or dose change. This timeline can help the pharmacist and prescriber evaluate the concern.
Ask About Cost and Easier Packaging
Medication problems are not always medical. Cost, complicated packaging, small print, and difficult schedules can prevent people from using medicines correctly.
Ask whether:
A generic or lower-cost option is available
Refills can be synchronized for the same pickup date
Larger-print labels are available
The pharmacy offers easy-open containers when appropriate
Blister packaging or another organization service is offered
Automatic refills could help
A simpler dosing schedule may be possible
Easy-open containers may not be suitable when children live in or visit the home. Discuss the household situation before requesting different packaging.
Do Not Stop a Medicine Without Guidance
A medication review may reveal questions that need to be sent to the prescriber. Pharmacists can explain directions, identify possible interactions, and suggest issues for follow-up, but they may not be able to change a prescription without authorization.
The National Institute on Aging’s guidance on taking medicines safely advises older adults to ask whether they still need every medicine while continuing to take prescriptions as directed. Some medicines can cause serious problems when stopped suddenly.
After the review, update the medication list and share it with relevant healthcare professionals and caregivers. Keep one copy at home and another in a wallet, purse, or phone for appointments and emergencies.
A careful medication review should leave the older adult with clear instructions: what each medicine is for, when to take it, what to avoid, and whom to contact when a problem occurs.
This article provides general educational information and does not replace advice from a pharmacist, physician, or other qualified healthcare professional.
