Older patients tend to accumulate drugs faster than they shed them, and each added agent raises the risk of interactions and adverse events. The review itself is the moment to push the other way.
For every drug, ask whether the original indication still applies, whether its benefit still outweighs its harm at the patient's current age and renal function, and whether the patient would choose to keep it. Stop one drug at a time, document the plan, and the repeat-prescription list becomes a considered one again.
- At each review, ask of every drug whether the original indication still applies.
- Weigh each drug's benefit against its harm at the patient's current age and renal function.
- Stop one drug at a time and document the plan so the change can be tracked.
- Ask the patient which medicines matter most to them.
Why it matters
Benefit and harm shift with age and renal function, so a drug once right can quietly become wrong.
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