How to do a medication review with the doctor — the conversation that saves lives
This article is meant to help you understand medication management better. It does not replace medical advice. Always consult with your parent's doctor before making changes to their medications.
Your mother has been taking the same medications for so long that nobody really thinks about them anymore. The pills sit in their bottles. She takes them. Life goes on. But you start to wonder: does her doctor even remember why she started taking all of these? Has anyone looked at the whole picture in the last two years? The answer, in most cases, is probably not.
A comprehensive medication review is one of the most valuable conversations you can have with your parent's healthcare provider. Unlike a routine office visit where doctors focus on current complaints, a medication review steps back and examines the entire pharmaceutical regimen. It asks questions that office visits often miss: Is this medication still needed? Is it working? Are there interactions? Could any of these symptoms actually be medication side effects? This conversation can be the difference between your parent struggling with confusion, dizziness, and constipation and your parent feeling clear and energetic.
Before the Appointment: Gathering Your Ammunition
The preparation for a medication review is more important than the visit itself. Your doctor can't review what they don't know about. Many patients take medications from multiple sources, don't remember exact doses, or forget to mention supplements and over-the-counter medications. Your job is to create absolute clarity.
Start gathering information at least a week before the appointment. Ask your parent to collect every medication container. This includes prescription medications from the past three years, over-the-counter products they use regularly or occasionally, vitamins, minerals, supplements, herbal remedies, and even topical medications like creams and ointments. Don't assume anything is too minor to mention. An aspirin taken twice a week matters. A multivitamin matters. That melatonin they take occasionally for sleep matters.
For each medication, write down the following information: the name of the medication, the dose (the number on the bottle), how many times per day they take it, when they start taking it (you don't need the exact date, just roughly how long they've been on it), and the doctor who prescribed it if you know. If you have any questions about why a medication was started, jot that down too. Include everything even if you think it's not important. The doctor can decide what matters.
If your parent has records from different providers or uses different pharmacies, call those offices and ask if they can provide a medication list. Pharmacies are excellent resources for this. The pharmacy where your parent fills most prescriptions has a complete record of what they've been dispensed. Call ahead and ask if they can print out a medication list you can bring to the appointment. Many will do this free.
Create a written list organized by condition if possible, or simply by medication name if you're not sure of the conditions. Make a copy to bring to the appointment and leave with the doctor. A paper list is better than a list on your phone because the doctor can have a hard copy for the file.
During the Appointment: The Questions That Matter
Schedule the medication review as a dedicated appointment rather than trying to squeeze it into a routine visit. Tell the office staff that you want to do a full medication review and ask how long to schedule. You need at least thirty minutes, and forty-five minutes is better. Some doctors have pharmacists available for this purpose, and requesting a pharmacist-led review is an excellent idea.
At the appointment, bring your written list and bring your parent if they're able to come. Some pharmacies or clinics send patients a form to complete before the visit, asking about medication use patterns. If you get a form, fill it out honestly. The doctor needs to know if your parent forgets to take medications, if they have difficulty with the pills, if they skip doses because of cost or side effects.
During the visit, go through the list methodically with the doctor. For each medication, ask these essential questions: Why was this started? Is it still needed? Is it still working? How do you know if it's working? What are the side effects we should watch for? Are there any interactions with other medications we should be concerned about?
Be specific about side effects you've noticed. Instead of saying "she seems forgetful," say "she forgets where she put her glasses, forgets conversations she had yesterday, sometimes struggles to find words." Describe how these problems have changed over time. When did they start? Are they getting worse or better? Could they be related to a medication change?
If your parent mentions side effects, ask the doctor whether the medication can be adjusted or changed. Some people tolerate different doses or different formulations better than others. A medication that causes side effects at one dose might work fine at a lower dose. Sometimes switching to a different medication in the same class works better.
Ask about stopping medications. A doctor won't suggest stopping a medication that's working and necessary, but they should consider it for medications that might no longer be needed or that started years ago for a problem that's now resolved. There's no harm in asking: "Could we try stopping this medication to see if he still needs it?" This gives your doctor permission to discuss deprescribing.
After the Appointment: Making Changes Safely
If the doctor recommends changes, get clear instructions on how to implement them. If a medication is being stopped, ask whether it should be stopped immediately or tapered gradually. Some medications need gradual reduction to prevent rebound problems. Ask what side effects to expect, if any. Ask what problems should trigger a call to the doctor.
If a medication is being changed, make sure you understand the new medication, new dose, and new schedule. Ask whether the new medication can interact with other medications your parent takes. Ask about common side effects and what to watch for.
If the doctor recommends reducing doses of a medication, ask for a specific schedule. "Take a lower dose" is too vague. You need to know exactly what your parent should be taking for exactly how long.
Request a new medication list from the doctor before you leave. The office should provide a printed copy listing all current medications with doses and schedules. Make copies for your parent, for yourself, for their pharmacist, and to keep in your files. If your parent uses multiple doctors or specialists, send a copy to each one. This prevents medications from being duplicated or interactions from being missed.
Follow up with the pharmacy. Tell your pharmacist about any medications being stopped or changed. Ask them to watch for interactions. Pharmacists are safety experts and often catch problems that doctors and patients miss. Your pharmacist is a valuable partner in your parent's medication safety.
Most importantly, involve your parent in this process. Help them understand why changes are being made. Explain what you're expecting to happen. Help them notice improvements or problems with changes. This conversation with your doctor is just the beginning. Your ongoing attention and advocacy is what keeps your parent safe and helps their medications work as well as possible.
Documentation and Long-Term Management
After the medication review, ask the doctor to document their recommendations clearly. Did they suggest stopping any medications? Starting new ones? Changing doses or timing? Request a written summary that both you and your parent can keep. This written documentation prevents confusion later about what was recommended and why.
Keep your own records. Take photos of all medication bottles with your phone. Create a spreadsheet with medication names, doses, prescribing doctors, and dates started. Update this regularly. When your parent sees a new doctor or specialist, provide a copy. Email a copy to their primary care doctor. Share it with the pharmacy. This documentation is your insurance policy against medications falling through the cracks.
The Follow-Up Conversation
The initial medication review is just the beginning. Schedule a follow-up appointment in four to six weeks to assess how the changes are working. Have your parent noticed improvements? Have any problems developed? Is the new medication working? Are side effects from stopped medications resolving? This follow-up visit allows you to catch problems early and make further adjustments if needed.
Many medication changes require monitoring. If a blood pressure medication dose was reduced, blood pressure needs to be monitored to ensure it stays in safe range. If a medication was stopped, the condition it was treating needs to be watched to ensure it doesn't worsen. Ask about what monitoring is needed and who will do it. Don't assume that once a medication change is made, monitoring happens automatically.
The Conversation With Your Pharmacist
After you've had the medication review with your doctor, have a conversation with your parent's pharmacist. Tell them about the recommendations and changes. Ask the pharmacist to review the entire medication list for interactions one more time. Ask whether the pharmacist sees any problems with the new regimen. Pharmacists often catch things doctors miss because they focus specifically on medication interactions and safety.
Ask the pharmacist about side effect profiles of medications your parent is taking. Ask what the most common side effects are and what side effects would require stopping the medication immediately. Ask whether your parent should take medications with food or on an empty stomach. Ask whether there are any foods or supplements to avoid while on specific medications.
Build a relationship with a pharmacist you trust. This person becomes another member of your parent's healthcare team. They're available by phone for quick questions. They know your parent's complete medication profile. They can often make medication changes easier and safer.
Making the Medication Review Ongoing
The medication review shouldn't be a one-time event. Your parent's health changes. New medications get started. Doses change. Each of these changes potentially affects the overall regimen and interactions. Make medication review an ongoing process.
Schedule a medication review with the doctor every one to two years as a standard practice. More often if your parent's health is changing rapidly or if new medications are being started. This regular review keeps medication regimens optimized and prevents the slow creep of unnecessary medications.
Between formal reviews, stay alert. After any doctor visit, ask whether medications were discussed. If a new medication was prescribed, understand why. If any medication was stopped or changed, understand the reasoning. Ask whether the prescribing doctor is aware of all other medications your parent takes. Be the person who keeps the whole picture in mind.
Your parent might feel supported rather than monitored by this ongoing attention. You're helping them manage a complex system that's difficult to manage alone. You're being their advocate. You're preventing harm and optimizing treatment. This is some of the most valuable support you can provide.
This article is meant to help you understand medication management better. It does not replace medical advice. Always consult with your parent's doctor before making changes to their medications.