Are all my medications necessary?

Are all my medications necessary?

(bestbeyond50.co.uk/post/new-blog-post-polypharma)

Short answer: probably not all of them — and there’s a good chance nobody’s ever reviewed your whole list together.If you take five or more medications, you’re entitled to ask your GP for a full Structured Medication Review. Here’s why that matters, and how to ask for one.

Doctors are trained, and generally very good, at starting medication. Something’s wrong, a prescription follows, you feel better (or you don’t, and another one gets added). What the system is far less good at is the reverse: circling back to ask whether everything you’re still taking is still earning its place. It seems half of them are to counteract the other half but are they all still really necessary? Before you know where you are you are rattling! You need a box with all the days separated and a PhD to work out what to take and when!

You are not the only one. My partner was in exactly this situation.

The scale of this is bigger than most people realise. Research across UK primary care has found that patients prescribed five or more medications have an annual medication error rate above 30%. In England alone, avoidable adverse drug events are estimated to cost the NHS more than £98 million a year, account for over 180,000 hospital bed-days, and contribute to around 1,700 deaths annually. This is common enough that it has an official name — polypharmacy — and NHS England, NICE and the British Geriatrics Society all now recommend a formal process for tackling it: the Structured Medication Review.

And yet, even where polypharmacy is flagged, only around half of patients taking five or more medicines get any kind of review at all, and fewer than one in five get the full structured version.

Why doesn’t anyone review my whole medication list at once?

It’s worth being precise here, because it would be easy — and unfair — to read this as “don’t trust your GP.” That’s not the point, and it’s not what the evidence supports.

The real issue is structural. Every appointment where something is added has a clear trigger: a symptom, a diagnosis, a blood test result. There’s rarely an equivalent trigger forremovingsomething. A medication started five years ago for a problem that’s since resolved, or alongside a dose that’s never been revisited as your weight, kidney function or other medications changed, can simply sit on the repeat prescription list indefinitely — not because anyone made a mistake, but because nobody’s job was ever to ask “does this still belong here?”

That’s what an annual medication review exists to catch. Deprescribing — the formal, supervised process of reducing or stopping medication that’s no longer needed or appropriate — is now a recognised clinical discipline in its own right, with its own guidance and tools And the good news is that it is something you can ask for.

What should I actually ask for?

Taking control of this doesn’t mean stopping anything yourself, and it doesn’t mean walking in distrustful of your GP or pharmacist. It means treating an annual medication review the way you’d treat a smear test or a dental check-up: a standing appointment you request, not something you wait to be offered.

Worth asking for, once a year:

•A full list of everything you take — prescription, over-the-counter, and any supplements — reviewed together in one appointment, not piecemeal.

•For each item: what it’s treating, whether that’s still current, and what happens if it’s reduced or stopped.

•Whether the combination could be causing side effects you’ve put down to “just getting older” — fatigue, dizziness, memory fog and low mood are all recognised medication side effects, not inevitabilities.

•A note of which medications are considered higher-risk for interactions or for your age group.

What are the red flags that a review is overdue?

•You can’t remember why you started one of your medications.

•You’re taking something “just in case” a symptom comes back.

•Nobody has looked at your full list together, only one item at a time.

•New side effects have appeared and been treated withanotherprescription, rather than a look at what’s already in the mix.

None of this requires confrontation. It’s a request, backed by NHS guidance that already exists — you’re simply asking for something you’re entitled to, that the system doesn’t always proactively offer.

Your medication list is part of your second chapter too

We talk a lot in this community about designing the years ahead rather than drifting through them. You are not a victim along for the ride. You are the one in control. Your body chemistry is very much part of that design brief. A medication list that’s been actively reviewed — rather than quietly accumulated — is one of the most concrete, low-effort things you can do for your long-term vitality.

Curious where you stand across the areas that matter most as you design this next chapter? Take our free Second Chapter Confidence Quiz— a few minutes, personalised results.

FAQ

Do I have to be on 5+ medications to ask for a review?No — anyone can request one, but NHS guidance specifically targets patients on five or more as a priority group, so you’re on strong ground asking if you’re in that bracket.

Will my GP think I’m criticising their prescribing?No. Structured Medication Reviews are NHS/NICE-recommended standard practice, not a complaint — you’re asking for a service that already exists.

How often should this happen?Annually is the general guidance, more often if your medications, weight, or kidney function change significantly.

This article draws on published NHS, NICE and British Geriatrics Society guidance on polypharmacy and structured medication reviews. It’s general information, not personal medical advice — always speak to your GP or pharmacist about your own medications before making any changes.

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