How to Review Medications for Safety & Appropriateness

By now you’ve probably heard that older adults are often taking “too many” medications. You’ve also hopefully found that seniors 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.

Geriatricians are trained to do these, 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:

“Senior Medication Safety Checklist“

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 a senior’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.

[Update November 2015: A very good NY Times article covers some of the recent research on overtreatment of hypertension and diabetes in older adults: Some Older Patients Are Treated Not Wisely, but Too Much.]

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

You may also find it useful to listen to 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!