How to do a medication review with the doctor — the conversation that saves lives

Reviewed by the How To Help Your Elders medical review team

If your parent has been taking the same medications for years and nobody has stepped back to ask whether every pill is still necessary, you're not alone. A dedicated medication review with the doctor is one of the most valuable conversations you can have, and for many families it uncovers problems that routine visits miss entirely.

A Medication Review Examines Every Prescription Your Parent Takes to Confirm Each One Still Belongs

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, for most families, is no.

A comprehensive medication review is different from a routine office visit where the doctor focuses on current complaints. A medication review steps back and examines the entire pharmaceutical regimen. It asks questions that regular appointments skip: Is this medication still needed? Is it still working? Are there interactions? Could any of these symptoms actually be side effects? According to the CDC, more than 40% of older adults take five or more prescription medications, and the AHRQ reports that adverse drug events account for over 700,000 emergency department visits per year, with older adults bearing the highest burden. 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 What You Need

The preparation matters more 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 products. Your job is to build a complete, accurate picture.

Start gathering at least a week before the appointment. Ask your parent to collect every medication container, including prescription medications, over-the-counter products they use regularly or occasionally, vitamins, minerals, supplements, herbal remedies, and 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. Melatonin taken occasionally for sleep matters.

For each medication, write down the name, the dose (the number on the bottle), how many times per day they take it, roughly how long they've been on it, and which doctor prescribed it. If you have questions about why a medication was started, note that too. Include everything and let the doctor decide what's relevant.

If your parent uses different pharmacies or sees multiple providers, call those offices and ask for a medication list. Pharmacies are excellent resources here. The pharmacy where your parent fills most prescriptions has a complete dispensing record. Call ahead and ask them to print a medication list you can bring to the appointment. Most will do this at no charge.

Organize the list by condition if possible, or simply by medication name. Make a paper copy to bring and leave with the doctor. A paper list the doctor can hold and write on tends to be more useful than a phone screen.

During the Appointment: The Questions That Change Everything

Schedule the medication review as a dedicated appointment. Tell the office staff you want a full medication review and ask how much time to schedule. You need at least thirty minutes, and forty-five is better. The FDA recommends that older adults taking multiple medications receive a comprehensive medication review at least annually. Some practices have pharmacists available for this purpose, and requesting a pharmacist-led review is an excellent option.

At the appointment, bring your written list and your parent if they're able to attend. If the practice sends a pre-visit form asking about medication use, fill it out honestly. The doctor needs to know if your parent forgets medications, has difficulty swallowing pills, or skips doses because of cost or side effects.

Go through the list methodically with the doctor. For each medication, the essential questions are: Why was this started? Is it still needed? Is it still working? How do we know it's working? What side effects should we watch for? Are there interactions with other medications on this list?

Be specific about problems you've noticed. Instead of "she seems forgetful," try "she forgets conversations from yesterday, sometimes struggles to find words, and has gotten lost driving to the grocery store twice this month." Describe how these problems have changed over time. When did they start? Are they worsening? Could they be connected to a medication change?

Ask about stopping medications. A doctor won't suggest stopping something that's working and necessary, but they should consider it for medications that might no longer be needed or that were started years ago for a problem that's now resolved. "Could we try stopping this medication to see if he still needs it?" gives your doctor explicit permission to discuss deprescribing.

After the Appointment: Making Changes Safely

If the doctor recommends changes, get clear instructions. If a medication is being stopped, ask whether to stop immediately or taper gradually. Some medications need gradual reduction to prevent rebound problems. Ask what to expect during the transition and what problems should trigger a call to the office.

If a medication is being switched, make sure you understand the new medication, the new dose, and the new schedule. Ask about interactions with everything else your parent takes. Ask about common side effects and what would require immediate attention.

If doses are being reduced, ask for a specific schedule. "Take a lower dose" is too vague. You need exact numbers for exact timeframes.

Request a new printed medication list before you leave. The office should provide an updated copy listing all current medications with doses and schedules. Make copies for your parent, yourself, the pharmacist, and your files. If your parent sees multiple 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 check for interactions with the updated list. Pharmacists are safety specialists and catch problems that doctors and patients miss. The AHRQ identifies pharmacist involvement in medication review as one of the most effective strategies for reducing adverse drug events in older adults.

Involve your parent in the process. Help them understand why changes are being made and what you expect to happen. Help them notice improvements or problems. The doctor visit starts the process. Your ongoing attention and advocacy keep it working.

Documentation and Long-Term Tracking

After the review, ask the doctor to document recommendations clearly in the medical record. What medications were stopped, started, or changed? What's the reasoning? Request a written summary for both you and your parent. This documentation prevents confusion later about what was recommended and why.

Keep your own records. Photo all medication bottles with your phone. Create a simple spreadsheet tracking medication names, doses, prescribing doctors, and start dates. Update it after every change. When your parent sees a new provider, share the list. Email a copy to their primary care doctor. Share it with the pharmacy. This documentation is your protection against medications falling through the cracks.

The Follow-Up

The initial medication review is just the beginning. Schedule a follow-up in four to six weeks to assess how changes are working. Has your parent noticed improvements? Have any problems developed? Is the new medication working? Are side effects from stopped medications resolving?

Many medication changes require active monitoring. If a blood pressure medication dose was reduced, blood pressure needs regular checking. If a medication was stopped, the condition it treated needs watching. Ask what monitoring is needed, who will do it, and how often. Don't assume that once a change is made, monitoring happens on its own.

The Pharmacist Conversation

After the doctor review, have a separate 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. Pharmacists focus specifically on medication safety and often catch things individual prescribers miss because they see the complete picture.

Ask about side effect profiles, which effects are common, which are serious, whether medications should be taken with food or on an empty stomach, and whether any foods or supplements should be avoided. Build an ongoing relationship with a pharmacist you trust. They become another member of your parent's care team, available by phone for quick questions and familiar with your parent's complete medication history.

Making This Ongoing

The medication review shouldn't be a one-time event. Your parent's health changes. New medications get added. Doses shift. Each change potentially affects the overall regimen and creates new interaction possibilities. The FDA and CMS both recommend that older adults on multiple medications receive medication therapy management annually.

Schedule a formal review every one to two years as standard practice, and more often if your parent's health is changing rapidly or new medications are being prescribed. Between formal reviews, stay alert. After any doctor visit, ask whether medications were discussed. If something new was prescribed, understand why. If something was stopped or changed, understand the reasoning. Ask whether the prescribing doctor is aware of everything else your parent takes.

Your parent may feel genuinely supported by this ongoing attention rather than monitored. You're helping them manage a system that's genuinely difficult to manage alone. You're being their advocate, preventing harm, and making sure their treatment stays optimized. This is some of the most valuable support you can provide.

Frequently Asked Questions

How often should my parent have a medication review?
At minimum, annually. The FDA and CMS recommend comprehensive medication therapy management at least once a year for older adults on multiple medications. If your parent's health is changing quickly, new medications are being added, or you're noticing new symptoms, schedule a review sooner.

Does insurance cover medication reviews?
Medicare Part D includes medication therapy management (MTM) services for qualifying beneficiaries at no additional cost. Qualification typically requires multiple chronic conditions and multiple medications. Many private insurance plans also cover pharmacist-led medication reviews. Ask your parent's plan specifically.

Should I bring all the medication bottles to the appointment?
Yes. Bringing the actual bottles eliminates guesswork about names, doses, and refill dates. It also reveals medications you might have forgotten to write down. Many doctors find this more helpful than a written list alone.

What if my parent's doctor doesn't want to do a full medication review?
Ask for a referral to a clinical pharmacist or geriatrician. Some doctors are pressed for time or don't consider comprehensive reviews part of their standard practice. A pharmacist-led medication therapy management session, covered by Medicare for qualifying patients, provides the thorough review your parent needs.

Can I request a medication review if I'm not the patient?
If you have your parent's permission or hold healthcare power of attorney, yes. If your parent is cognitively impaired and you're their designated decision-maker, you have every right to request and participate in a medication review. Bring documentation of your legal authority to the appointment.

What if different doctors disagree about which medications to keep?
This is common when multiple specialists are involved. The primary care doctor should serve as the coordinator who weighs all perspectives and makes the final call on the overall regimen. If disagreements persist, a geriatrician or clinical pharmacist can provide an independent assessment.