Could you be taking more medicines than you really need?
Taking several different medicines is common, particularly as we get older or develop long-term health conditions. But could some of those medicines be doing more harm than good?
Taking five or more prescribed medicines is known as polypharmacy, and while it is often necessary, it can increase the risk of side effects and interactions between medications.
Here, our GP Dr Katie Platts explains why it’s important to regularly review the medicines you’re taking, how to recognise potential problems and why you should never stop taking prescribed medication without speaking to your doctor.
A recent series of articles, published by the Sunday Times newspaper, has raised concerns about over-prescribing of medications, leading to potentially harmful side effects and increasing A&E attendances.
Polypharmacy is the medical term used when a person is taking five or more prescribed drugs. This is an increasingly common reality in the UK, affecting roughly eight million people – or 15% of the population – with more than two million individuals managing an even heavier regimen of 10 or more medicines each day.
Recent data from the UK highlights a growing concern for our older community, revealing that approximately 1,000 elderly individuals are admitted to hospital each day due to adverse medication side effects. Even more worryingly, coroners have increasingly identified polypharmacy as a key factor contributing to preventable deaths.
Now before you start throwing everything in your medicine cupboard away, please don’t! For many people, these medicines are essential and are playing an important role in keeping good health. That’s why regular medication reviews are so important. The aim isn’t simply to reduce the number of tablets you take. It’s about making sure that every medicine you take is still doing something useful, and that the benefits continue to outweigh the risks.
So, how can we make sure our medicines are helping us rather than causing problems of their own?
Do you still need all those medicines?
As we get older, our bodies change, and the medicines we need change too. For example, when you are younger, taking pills for high blood pressure is very important to prevent heart attacks and strokes. But as we age, blood pressure often drops naturally. If it gets too low, it can make an older person dizzy and cause a dangerous fall. For older or frail adults, it can sometimes be safer to have a blood pressure that is a little bit higher rather than risk a nasty fall from over-treatment.
That is why doctors often need to ‘deprescribe’. This just means safely lowering or stopping medicines that someone doesn’t need anymore. It’s not about stopping medication for the sake of it. It’s about making sure the treatment still makes sense for the person sitting in front of us.
Could one medicine be causing the need for another?
No drug is without side effects. Sometimes, doctors will give you a second pill just to treat a side effect caused by the first one, such as taking a laxative because a painkiller makes you constipated. But this can easily snowball. You can end up taking a third pill for the side effects of the second pill, and so on. Not only can this be frustrating and inconvenient, but taking several different medicines also increases the risk of them interacting with one another.
Regular check-ups, and a full medication review every time a medication is started, can help prevent this sort of prescribing cascade.
Who is keeping track of all your medicines?
GPs frequently refer patients to different hospital specialists. Patients often return from these appointments with new prescriptions. If you are seeing several different specialists, your medication list can grow surprisingly quickly.
While these prescriptions may very well all be necessary, it remains crucial for your GP to maintain a complete overview of your care. This oversight ensures that medications from different sources do not interact dangerously with one another. Remember, this includes over-the-counter medicines, herbal remedies and supplements too. Don’t forget to tell your GP if you are taking any non-prescription treatments.
Do you know what each of your medicines is actually for?
Understanding what your medication is for, and how to take it properly, is an important part of staying safe. Some medicines need to be taken separately because taking them together can affect how well they work. For example, taking iron tablets at the same time as a stomach-acid reducer, such as omeprazole, can stop your body properly absorbing the iron.
It is also vital to know exactly why you are taking each medicine so you can spot when you might not need it anymore. For instance, if you are taking regular pain medication but are no longer suffering from pain, it’s worth asking your doctor whether you still need it rather than simply continuing out of habit. Use that awareness to ask your doctor if it is time to safely reduce your dose.
Conversely, some medications are prescribed purely to protect your health in the future, even if you feel completely fine right now. Common examples include treatments for high blood pressure, high cholesterol and early diabetes. You may not feel any different when you take them, but they can be working quietly in the background to keep you well. Because of this, it is helpful to understand how they are benefiting you and to never stop a prescribed medication without first speaking with your doctor.
Is a pill always the answer?
Sometimes medication is absolutely the right answer. But sometimes there are other things that can help too. When managing health conditions, it’s easy to assume that every new symptom needs a new prescription. However, non-medicine options can often work beautifully alongside medication and, in some cases, may even be a better choice.
By thinking about the whole picture, we can sometimes address the underlying problem without adding another medicine to an already busy daily medication list.
Lifestyle and dietary choices can be surprisingly powerful in preventing and managing chronic conditions. For example, robust medical evidence favours exercise therapy over opioids for managing chronic back pain. While opioid painkillers provide only small, short-term relief and carry a risk of dependence, regular physical activity can improve both pain and long-term physical function.
What we eat can make a difference too. A colourful, fibre-rich diet alongside plenty of water can help with constipation and may reduce the need for laxatives. Similarly, individually tailored dietary changes can often help manage conditions such as irritable bowel syndrome.
And sometimes, simply moderating our intake of certain things can make a real difference. Reducing or stopping caffeine, alcohol, smoking and spicy foods can help to soothe indigestion, and may reduce the need for acid-reflux treatments. Cutting back on alcohol can also improve sleep, reduce bladder urgency, and help to stabilise mood, thus potentially reducing the need for sleeping pills, bladder medication, or antidepressants. Similarly, reducing caffeine can help with insomnia, gut and bladder irritation, and uncomfortable heart palpitations.
Before automatically adding another pill to the list, it’s always worth asking: is there something else that could help?
Could Bran make your next medication review easier?
No, not the cereal – this is a simple acronym that can help guide shared decision-making with your doctor:
B for benefits: What are the benefits of taking this medication? How will it help my condition?
R for risks: What are the risks or potential side effects? Are there any drug interactions I should worry about?
A for alternatives: What are the alternatives? Are there other medications, therapies, or lifestyle changes available?
N for nothing: What happens if I do nothing? What are the consequences of delaying or refusing the treatment?
So, the next time you see your GP, consider using the Bran framework. It could very well transform your next medication review from a routine check-up into a powerful, two-way conversation about your health. You may discover that some medicines are essential, some could potentially be reduced, and some may no longer be needed at all.
And, with any luck, you might even cut that medication list in half.
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