Quick answer. Polypharmacy means taking many medicines at once, commonly five or more, which is very common in older adults in Singapore who often have several chronic conditions. Taking many medicines can be necessary, but it also raises the risk of side effects, drug interactions, falls, confusion and hospital visits. A regular MEDICATION REVIEW with your doctor or pharmacist checks that every medicine is still needed, safe and working, and may safely ‘deprescribe’ (reduce or stop) ones that are no longer helping. Bring ALL your medicines (including supplements) to appointments, and never stop a medicine on your own, always check with a doctor or pharmacist first.
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Many older adults in Singapore live with several long-term conditions, so it is common to be taking a handful, or more, of different medicines, plus supplements bought over the counter. Each one may be needed, but as the list grows, so does the chance of side effects, interactions, and problems like dizziness, falls or confusion.
This is where a medication review comes in. It is a friendly, structured check, usually by a doctor or pharmacist, of everything you take, to make sure each medicine is still doing more good than harm. This guide explains why it matters, what ‘deprescribing’ means, and how you and your caregiver can prepare.
At a glance
| Concern | Why it happens in older adults | How a review helps |
|---|---|---|
| More side effects | 5 to 9 medicines ~2x risk; 10+ ~3x risk | Spots medicines causing the trouble |
| Drug interactions | Several medicines (and supplements) acting together | Checks for harmful combinations |
| Falls and dizziness | Sedatives, blood pressure and sleep medicines | Adjusts or reduces risky medicines safely |
| Confusion / drowsiness | Brain more sensitive to some drugs with age | Reviews and simplifies the regimen |
| Hard to keep track | Many pills, different times, multiple doctors | Simplifies timing; one clear, updated list |
What polypharmacy is, and why it grows with age
Polypharmacy simply means taking multiple medicines, often defined as five or more. It is not automatically ‘bad’, many older people genuinely need several medicines to control conditions like high blood pressure, diabetes, heart disease and pain. The issue is that lists tend to grow over time: different doctors add medicines, new ones are started to treat the side effects of old ones, and some are continued long after they are still needed. The aim is the right medicines, at the right doses, for the right reasons.
The risks of taking many medicines
The more medicines a person takes, the higher the chance of problems:
- Side effects: those on 5 to 9 medicines face roughly double the risk, and 10 or more around triple, compared with taking fewer than five
- Drug interactions, where medicines (or supplements) clash
- Falls and fractures, especially with sedatives, sleeping pills and blood-pressure medicines that cause dizziness
- Confusion, drowsiness or memory problems
- Missed or doubled doses when the routine is complicated
- Hospital admissions from preventable adverse drug reactions
Many of these are preventable with a good review.
What a medication review involves
A medication review is a calm, thorough look at everything you take, prescription medicines, eye drops, creams, inhalers, traditional and herbal remedies and supplements. Your doctor or pharmacist will ask what each one is for, whether it is still helping, whether you have side effects, and how you actually take it. They check for duplicates, interactions and medicines that are risky in older people. It is a two-way conversation, your questions and concerns are an important part of it.
Deprescribing: safely reducing medicines
Deprescribing is the planned, supervised process of reducing or stopping medicines that are no longer needed or may be causing harm, while keeping the ones that help. It is done with you, usually one medicine at a time, with a clear plan and follow-up to make sure you stay well. Deprescribing is a positive step, fewer unnecessary pills can mean fewer side effects and a simpler routine. Crucially, it should always be guided by a doctor or pharmacist, never done by stopping medicines on your own.
How to prepare: bring your medicines
The single most helpful thing you can do is the ‘bring all your medicines’ approach:
- Put every medicine, supplement and remedy (in their original boxes) into one bag and bring them to your appointment
- Include things from other clinics, pharmacies or bought overseas
- Bring a written list with names, doses and timings if you have one
- Note any side effects, allergies, or pills you find hard to take or often forget
- Tell the doctor which medicines you actually take versus skip
This gives a true picture and makes the review far more accurate.
Tips for seniors and caregivers
- Keep one updated medicine list and update it after every change
- Use a pill organiser or ask the pharmacy about packing doses by time
- Ask, for each medicine: What is it for? Is it still needed? What are the side effects?
- Never stop or change a medicine on your own, some must be reduced gradually
- Use one regular pharmacy where possible so interactions can be checked
- Ask your polyclinic or hospital pharmacist about a medication review, they are there to help
Related guides
- Best Geriatric Medicine Clinics in Singapore — our editorial shortlist
- Incontinence in the elderly
- Delirium (sudden confusion)
- Malnutrition in the elderly
Sources
- HealthHub – Medications and supplements information
- Polypharmacy among community-dwelling elderly in Singapore (study)
- Reducing medication errors among older adults in Singapore (review)
- Singapore Med J – Deprescribing in older patients
- AIC – Caregiving support and services
Related conditions & guides
Related conditions and guides you may find useful:
- Caring for Elderly Parents in Singapore
- Comprehensive Geriatric Assessment in Singapore
- Dementia and Memory Loss in Singapore
- Falls Prevention for the Elderly in Singapore
- Frailty and Healthy Ageing in Singapore
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