What a medication review is really for

Many people imagine a medication review is simply “checking repeats” or “ticking boxes for the computer”. In reality, the deeper purpose is more human:

• To see whether every medicine you take is still pulling its weight.
• To notice medicines that may now be doing more harm than good.
• To bring how you feel – your tiredness, balance, sleep, bowels, memory, mood – into the same picture as your prescription list.
• To give you a safe space to say, “I’m not sure these tablets are helping me any more.”

Your GP or pharmacist brings their clinical training; you bring the only thing they cannot see on a screen – what it is like to live inside your body, day after day, on these medicines. Preparing well is about making sure both sides of that picture show up.

Before you even look at the boxes: noticing “how life feels”

The quiet information that helps most at a review often isn’t printed on any label. In the week or two before your appointment, it can help to gently notice:

• Energy: Are there times of day when you regularly feel heavy, drowsy or “wiped out”?
• Balance and walking: Any new wobbles, near-falls or hesitations on steps?
• Thinking and mood: Do you feel foggier, flatter or more anxious than you did a year ago?
• Sleep: Is your sleep broken, or are you sleeping so heavily you struggle to wake?
• Everyday life: Have medicines quietly stopped you doing things you enjoyed – walking to the shop, attending church, joining a group?

You do not have to prove that any of this is “because of” a particular tablet. Just bringing honest observations gives your clinician clues that no blood test can provide.

What to bring to a GP or pharmacy medication review

Reviews go better when the whole story is in the room. If you can, gather:

• All your current medicine boxes and bottles – including inhalers, eye drops, creams, patches and sprays.
• Anything you take without a prescription – painkillers, herbal remedies, vitamins, sleeping tablets bought over the counter.
• Your latest blood pressure or blood sugar readings if you check these at home.
• Your medicines list if you have one (PHAT has a separate guide on building this at home).
• Your glasses and hearing aids – you will take in more if you can hear and read comfortably.
• A support person you trust – a friend or relative who can help you remember what was said, if you wish.

You might also want a small bottle of water and a snack in your bag. It sounds simple, but low blood sugar or thirst can make you feel more anxious and muddled, just when you are trying to think clearly.

Building a short, powerful question list

Most older adults walk into a review with a swirl of thoughts, then leave saying, “I forgot to ask about the main thing.” A written list, however small, turns that swirl into a plan.

On a page headed “Questions for my medication review”, consider including three types of questions:

1. Questions about necessity

• “Do I still need every one of these medicines at my age and in my current health?”
• “If we were starting from scratch today, would you still choose all of these for me?”
• “Are any of these medicines mainly for numbers on a screen, rather than how I feel day to day?”

2. Questions about side effects and burden

• “Could any of these medicines be contributing to my dizziness, falls, constipation, memory problems or low mood?”
• “Are there tablets that are more likely to make older people confused, wobbly or very sleepy?”
• “If we think a tablet is causing problems, how would we safely reduce or stop it?”

3. Questions about simplifying

• “Is there any way to simplify the timing – for example, more things together in the morning or at night?”
• “Are there any medicines that could be changed to once-daily versions?”
• “If my priorities are independence and clear thinking, which medicines matter most to protect that?”

You don’t have to ask everything. Choose the two or three questions that feel most important and circle them. If there is time for more, that is a bonus.

Preparing your “headline” for the appointment

Clinicians think in patterns. One of the strongest things you can do is start the review with a clear headline sentence that sets the tone. For example:

• “I would like us to look at whether all of these medicines are still helping me, because I feel more tired and unsteady than last year.”
• “I’m managing, but it’s a lot to keep track of. I’d like to know if there is any safe way to simplify what I’m taking.”
• “My main worry is falls and my memory. Could we look at my medicines with that in mind?”

This one sentence acts like a compass for the whole conversation. If things drift into small details, you can gently bring it back: “I’m still most concerned about my tiredness and balance – could that link to any tablets?”

What your GP or pharmacist quietly hopes you will tell them

There are a few pieces of “rare” information that professionals often have to guess, because people are shy to say them out loud. If you can share them openly, the review becomes far more useful:

• What you actually take – not what the computer says you should take. If you miss doses, halve tablets or avoid some altogether, say so honestly. The aim is safety, not judgement.
• What you have stopped yourself – sometimes people quietly stop painkillers, antidepressants or sleeping tablets. Your team needs to know, especially if blood results or symptoms change.
• Whether the routine is realistic – if a lunchtime tablet is always missed because you are out or asleep then, it is better to say so than pretend it is fine.
• Any beliefs or fears about medicines – for example, “I’m frightened of addiction”, “I’m worried they’re damaging my kidneys”, or “I feel like a burden to the NHS”. These shape how you take your medicines just as much as side effects do.

A good clinician would always rather work with the truth than with a “perfect” picture that doesn’t match your real life.

Making the room friendlier for your brain and body

Medication reviews often happen in small rooms with bright lights, bleeping alarms and computers. That environment can make anyone feel tense or forgetful. A few quiet adjustments can protect you:

• Let reception know if you struggle with hearing so they can speak clearly and, if needed, note this for the clinician.
• If you use a walking aid, make sure the chair offered is stable and at a height you can get out of safely.
• Ask if the clinician can sit facing you, not with their back turned to the computer the whole time – it is easier to follow what is being said.
• If medical words become overwhelming, it is okay to say, “Could you say that in simpler language for me?”

Remember: you are allowed to pause the conversation, sip water, take a breath and gather your thoughts. You are not being difficult; you are protecting your ability to make good decisions.

After the review: capturing decisions and next steps

Many people leave an appointment thinking, “That sounded good, but I’m not sure what we actually decided.” Before you leave the room, try to get three things clear:

• What is changing? – “We are increasing this tablet”, “We are stopping that one over four weeks”, “We are not changing anything today”.
• How will we know if it’s working? – “My ankles should swell less”, “I should feel less dizzy”, “My numbers should settle within three months”.
• When we will review again – “In six weeks with the pharmacist”, “At my next diabetes check”, “Sooner if I notice X, Y or Z”.

If you like, you can say:

“Could you help me write down the three main actions from today, in my own words, before I go?”

When you get home, add any changes to your medicines list and keep any old boxes separately ready to return to the pharmacy, so your cupboard reflects the new plan.