byMcGill University

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To address the growing problem of overprescribing for seniors, a new Canadian guideline is calling for routine medication reviews. In Canada, roughly two in three adults age 65 or oldertake five or more medications. While often necessary, complex drug regimens can increase the risk of side effects and affect quality of life.

The studyunderpinning the guideline – co-led by researchers at McGill University and the University of Toronto and developed by an interdisciplinary panel of experts – aligns withfederal legislationcalling for a strategy on appropriate medication use. The work is published in the journalCanadian Family Physician.

"We have a significant issue with overprescribing in Canada and globally. Patients taking 10, 15 or even 20 medications are not uncommon," said co-lead author Dr. Emily McDonald, Associate Professor in McGill's Department of Medicine.

Complex drug combinationsare rarely studied together and can interact in unpredictable ways, contributing to falls, confusion, bleeding complications, and other effects that are often mistaken for normal aging.

As there has been little guidance for clinicians, medication reviews often happen only after a complication arises, she added.

A shift toward prevention

Drawing on evidence from more than 100 clinical trials, the guideline recommendsannual medication reviewsfor adults 65 or older, particularly those taking five or more medications. The goal is to catch unnecessary or potentially harmful prescriptions and, where appropriate, safely reduce or stop them.

The authors also highlight the need for government support to help make these checkups more widely available through physicians, pharmacists, and nurse practitioners.

What this means for patients

Patients don't need to wait for their health care provider to initiate a prescription checkup, said McDonald. Seniors taking multiple medications are encouraged to ask for one, usingfive key questionsto guide the discussion.

"Patients should understand their medications and feel empowered to ask whether non-drug options are possible," said McDonald, who also directs the Canadian Medication Appropriateness and Deprescribing Network.

The network'sMedication Review Service Findercan help users findpublicly fundedmedication review services in their area.

More information Emily G. McDonald et al, Screening for potentially inappropriate prescribing in primary care, Canadian Family Physician (2026). DOI: 10.46747/cfp.7203173