7 signs your parent may be on too many medicines

Search this question and most of what comes back is American: Medicare Part D rules, US pharmacy benefit language, medicine names your parent’s box has never carried. None of it tells you what to actually do here. In Australia the answer is more concrete. If any of the signs below sound familiar, it may be worth asking an eligible medical practitioner whether a Home Medicines Review (HMR) is clinically appropriate. In a funded HMR, a credentialed pharmacist reviews the medicines at home and the service must be provided at no charge to the patient. A separate appointment with the referrer may have its usual fee.

The seven signs

1. The medicine list only ever grows

Five medicines becomes eight, becomes twelve, and nobody sits down to ask whether all of them are still pulling their weight. Taking five or more medicines regularly is common enough to have its own clinical term, polypharmacy, and it is more common in Australia than most families realise: 40% of Australians aged 75 and over are dispensed more than five medicines at the same time, compared with an OECD average of 32%.¹ Polypharmacy isn’t automatically a problem — some people genuinely need every item on a long list. It is, though, a reason to check the list as a whole rather than one prescription at a time.

2. New confusion or drowsiness after a medicine change

If your parent seemed steady before a new tablet was added or a dose was changed, and became noticeably more confused, drowsy or “not themselves” afterwards, that timing is worth paying attention to. Some medicines commonly used by older people, including certain sleeping tablets, strong pain relief and some bladder, allergy and sleep medicines, can affect thinking and alertness more in older people than in younger adults.² Their doctor is the one who can work out whether a medicine is the cause — but the timing is exactly the detail worth telling them.

3. Dizziness or unsteadiness on their feet

Medicines can affect balance and coordination as a side effect, not only as a normal part of getting older. If your parent has become noticeably wobblier, or you’ve noticed them steadying themselves on furniture more than they used to, it’s worth mentioning to their GP alongside their current medicine list, not as a separate, unrelated concern. Blood pressure medicines, sedatives and some pain relief can all contribute to this in ways that are easy to attribute to age alone.

4. Several doctors prescribing without one person seeing the whole picture

A GP, a cardiologist, perhaps a specialist for something else entirely — each one doing their job well, but nobody necessarily holding the complete list at once. This is one of the most common and most fixable situations an HMR is designed for: a pharmacist gathers every medicine from every source into one report for the referrer and, when different, your parent’s regular GP.

5. Doses missed or doubled

The Webster pack still has Tuesday’s tablets in it on Thursday. Or you find two boxes of the same medicine, started at different times by different doctors, without either doctor knowing about the other. These aren’t signs of carelessness — they’re exactly what happens when a medicine routine grows more complicated than any one person can track without help.

6. Medicines continued for years without a clear reason

Something started after a hospital stay years ago, or for a problem that resolved long since, and nobody has asked since whether it’s still needed. Long-standing medicines aren’t wrong by default — but “we’ve just always kept taking it” is worth checking rather than assuming. A structured review is one of the few points in the system where that question actually gets asked, rather than each prescription simply being renewed on schedule.

7. Side effects treated with more medicines

A medicine causes a side effect. That side effect gets treated as a new problem, and a second medicine is prescribed for it. In pharmacology this pattern has a name: a prescribing cascade — a new medicine started to manage a symptom that was actually caused by an earlier one, on the understandable but mistaken assumption that a new condition has appeared. It’s easy to miss because each individual decision made sense at the time it was made. Spotting it usually takes someone looking at the whole list together, not each prescription on its own.

What actually helps

A Home Medicines Review starts with an eligible medical practitioner’s referral. A credentialed pharmacist then visits your parent at home, goes through every medicine — prescription, over-the-counter, vitamins, the lot — and writes a report for the referrer and, when different, the regular GP. Medicine changes remain the prescriber’s responsibility. A funded HMR must be provided at no charge to the patient; a separate referrer appointment may have its usual fee.

If you’re not sure how to raise it with their GP, our guide to organising a medication review for your parent walks through what to say. And if what you’ve noticed is more specifically confusion since a medicine changed, our article on medicine side effects or dementia covers that situation directly. None of this requires you to have the answer yourself — noticing the pattern and saying it out loud to your parent’s GP is the part that matters. The review itself is designed to do the rest.

If your family is in Roxburgh Park, the Roxburgh Park HMR pharmacist page has local detail on how this works near you, and HMR pharmacist Melbourne covers eligibility and cost in full.

References

1. Australian Institute of Health and Welfare, OECD health care quality and outcomes indicators, Australia 2022–23 — Prescribing in primary care: aihw.gov.au
2. healthdirect, Medicines safety for older people: healthdirect.gov.au
3. Australian Commission on Safety and Quality in Health Care, Information about polypharmacy — Easy read: safetyandquality.gov.au
4. Pharmacy Programs Administrator, Home Medicines Review: ppaonline.com.au