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Polypharmacy priorities — DGM MCQ

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ModeratePolypharmacyPolypharmacy prioritiesDGM

An 87-year-old woman takes 16 regular medicines and has frailty, falls and poor appetite. She wants fewer tablets and says pain control matters most. Several medicines are for long-term prevention. Current medicines include multiple cardiovascular, analgesic and gastrointestinal medicines. What is the most appropriate management?

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Correct answer: E — Shared decision-making medicines review focused on goals and benefit horizon

In multimorbidity and frailty, medicines review should align treatment with goals, harms, benefit horizon and patient priorities. Stopping everything abruptly is unsafe, rigid single-disease prescribing increases burden, adding medicines first worsens polypharmacy, and larger boxes do not solve appropriateness. Good prescribing in geriatrics includes deprescribing and prioritisation.

Reference: NICE NG56; STOPP/START criteria v3