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Complex polypharmacy review — DGM MCQ

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HardPolypharmacyComplex polypharmacy reviewDGM

An 88-year-old woman takes 14 regular medicines and has had two emergency admissions in 3 months. She has frailty, CKD stage 3 and postural dizziness. Her daughter brings a bag containing duplicate inhalers, two PPIs and expired antibiotics. What is the most appropriate management?

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Correct answer: A — Structured medication review using goals, indications and STOPP/START principles

A structured medication review should reconcile actual use, indications, benefit, harm, adherence and patient goals. Stopping every preventive medicine is unsafe and misses under-prescribing, while a compliance aid can perpetuate inappropriate therapy. Polypharmacy review should be both deprescribing and appropriate prescribing.

Reference: NICE NG56; STOPP/START criteria v3