Polypharmacy Risk Calculator
This tool helps you understand your risk of medication-related problems based on the number of medications you take and key medication types. Brown bag medication reviews are recommended for anyone on multiple medications to identify potential issues and improve safety.
Your risk level is low.
Consider a brown bag medication review every 1-2 years.
Imagine this: you’re sitting in your doctor’s office, trying to explain what pills you take every day. You remember the big ones - your blood pressure medicine, your diabetes pill, maybe your vitamin D. But you forget the sleep aid your sister gave you last month. You don’t mention the ibuprofen you take for your knee. You didn’t think the fish oil counted. And you haven’t opened that bottle of thyroid medicine in six months - but you still keep it in the drawer. Sound familiar? You’re not alone. Most people don’t realize how many medications they’re actually taking - or why.
This is where the brown bag medication review comes in. It’s not fancy. No apps, no portals, no login screens. Just you, a brown paper bag, and every single thing you swallow, rub on your skin, or inhale. It’s simple. It’s old-school. And it’s one of the most effective ways to stop dangerous drug mistakes before they happen.
What Exactly Is a Brown Bag Medication Review?
A brown bag medication review is exactly what it sounds like. You gather every medication you take - prescription, over-the-counter, vitamins, supplements, herbal teas, creams, inhalers - and put them all in a brown paper bag. Then you bring that bag to your doctor or pharmacist for a full checkup. The goal? To make sure nothing’s overlapping, nothing’s expired, nothing’s unnecessary, and nothing’s hurting you more than helping.
This practice started in the early 1980s in the U.S., when pharmacists began handing out brown supermarket bags to patients so they could collect their meds at home. The name stuck. Today, it’s used in clinics across the U.S., Canada, and parts of Europe. In Australia, it’s gaining traction in aged care and community pharmacy programs. Why? Because it works. Studies show that when patients bring their actual pills, medication lists are accurate 92-95% of the time. When they just try to remember? Only 13-20% accurate.
That gap isn’t just a mistake. It’s a safety risk. Up to 20% of hospital admissions for older adults are caused by medication errors. Many of those could be avoided with a simple brown bag review.
Why This Matters More Than Ever
By age 65, nearly 90% of Australians take at least one prescription. More than half take five or more. That’s called polypharmacy - and it’s not always bad. But when you’re taking eight different pills from four different doctors, and you’re also popping melatonin, turmeric, and a magnesium supplement, things get messy.
Here’s what can go wrong:
- You’re on two different blood pressure meds that do the same thing - doubling your risk of low blood pressure.
- You’re taking a painkiller that interacts with your heart medication, causing dizziness or falls.
- You’re still taking an antibiotic from last year’s infection - and your liver doesn’t know it’s not needed anymore.
- You’re using a sleep aid that makes your dementia symptoms worse.
And here’s the kicker: most people don’t even know they’re doing it. A 2023 study found that 68.3% of seniors who had a brown bag review discovered at least one dangerous or unnecessary medication. In one case, a man was taking two different beta blockers - from two different doctors - and didn’t realize it. He was dizzy all the time. His symptoms vanished after one pill was stopped.
These aren’t rare cases. They’re routine.
What to Put in the Bag
Don’t guess. Bring everything. Even the stuff you think doesn’t count.
- All prescription meds - pills, liquids, patches, inhalers, eye drops, creams.
- All over-the-counter drugs - pain relievers (ibuprofen, acetaminophen), antacids, allergy pills, cough syrups.
- All vitamins and supplements - multivitamins, calcium, vitamin D, omega-3s, B12, CoQ10.
- All herbal remedies and teas - St. John’s Wort, ginkgo biloba, echinacea, chamomile, turmeric capsules.
- All unused or expired meds - yes, even the ones you haven’t touched in a year.
Don’t just grab the bottles. Bring the actual packaging. The labels have important info: dosage, frequency, prescribing doctor, pharmacy name. If you’re not sure whether something counts, bring it anyway. Better safe than sorry.
Pro tip: Keep a small tote bag in your closet or drawer just for this. Every time you refill a prescription, toss the bottle in. That way, when your review is due, you’re not scrambling.
How to Prepare for the Appointment
A brown bag review isn’t a quick chat. It takes 30 to 45 minutes. Plan for it.
- Collect everything - at least 24 hours before your appointment. Don’t wait until the morning of.
- Write down your routine - even if you think your provider knows it. Example: “I take the blue pill at breakfast, the white one at bedtime, and the green one if I feel chest tightness.”
- Bring your questions - Why am I taking this? Is this still needed? Can I stop one? What happens if I skip it?
- Bring a family member - Especially if memory or hearing is an issue. Two sets of ears help.
- Don’t skip the expired meds - Your provider needs to know what’s sitting in your cabinet. Some can be dangerous if taken after expiry.
And here’s something most people don’t think to ask: “Can I stop any of these?” Many seniors are on meds they no longer need - maybe because a condition improved, or a doctor changed, or they were prescribed for a short-term issue that became permanent by accident.
In one Bexley and Greenwich pilot study, 63.8% of patients had at least one unnecessary medication removed after a review. That’s not just fewer pills - it’s fewer side effects, fewer falls, fewer hospital trips.
What Happens During the Review
Your provider will lay out everything you brought. They’ll compare it to your medical records. They’ll look for:
- Duplicates - Two drugs doing the same job.
- Interactions - Medications that clash (e.g., blood thinners + fish oil).
- Outdated prescriptions - Drugs you haven’t used in months or years.
- Incorrect dosing - Taking too much or too little.
- Lack of purpose - A pill with no clear reason for being taken.
They’ll also ask you questions:
- “Do you ever skip doses?”
- “Do you feel any side effects after taking these?”
- “Do you know what each one is for?”
This is where the teach-back method works best. Your provider will explain something - then ask you to repeat it back in your own words. If you can’t, they’ll re-explain. It’s not a test. It’s to make sure you truly understand.
At the end, you’ll get a new, updated list. No more guesswork. Just clear instructions: what to take, when, why, and what to stop.
Common Problems - And How to Avoid Them
Not everyone gets it right. Here’s what goes wrong - and how to fix it.
Problem 1: “I forgot half my meds.”
Solution: Keep a running bag. Put new meds in it as soon as you get them. Make it a habit - like brushing your teeth.
Problem 2: “I was embarrassed to bring all my pills.”
Solution: Your provider has seen it all. They’ve seen drawers full of expired antibiotics, cabinets full of supplements, and patients taking 15 pills a day. They’re not judging. They’re helping.
Problem 3: “I didn’t know what to bring.”
Solution: If you’re unsure, bring it. Even if it’s a tiny bottle of melatonin. Even if it’s a cream for your rash. Better to bring too much than too little.
Problem 4: “The appointment felt rushed.”
Solution: Ask for a dedicated 45-minute slot. Say: “I’m bringing my brown bag for a full medication review.” Most clinics now schedule these separately for a reason.
Problem 5: “I didn’t understand what they told me.”
Solution: Ask for a printed list. Ask for a follow-up call. Ask for a family member to join the next one. You have the right to understand your own treatment.
Who Should Do This - And How Often
This isn’t just for seniors. But it’s most critical for them.
People over 65 are the biggest candidates. On average, they take 4.7 prescriptions and 1.9 OTC meds. That’s a lot of room for error.
But if you’re on five or more medications - no matter your age - you should do this. Same if you’ve been hospitalized recently. Or if you’ve had a fall, confusion, or unexplained fatigue.
How often? At least once a year. But if you’ve had a major change - new doctor, new diagnosis, new hospital stay - do it right away.
And if you’re a caregiver: don’t wait for your loved one to remember. Help them prepare. Go with them. Ask the questions they’re too shy to ask.
The Bigger Picture: Why This Is a Safety System, Not Just a Checkup
Brown bag reviews aren’t just about pills. They’re about control. About clarity. About safety.
Medication errors are one of the leading causes of preventable harm in older adults. And they’re often invisible - until it’s too late.
By bringing your actual meds, you’re not just giving your doctor information. You’re giving them truth.
It’s not perfect. It’s not high-tech. But it’s real. And it works.
Major health systems like Kaiser Permanente and Mayo Clinic now make these reviews mandatory for patients over 65. Medicare is pushing for 100% of Annual Wellness Visits to include them by 2026. Why? Because they’ve seen the data: fewer hospitalizations, fewer falls, fewer deaths.
This isn’t a trend. It’s a standard. And it’s yours to use.
What to Do Next
Here’s your action plan:
- Find your next doctor or pharmacist appointment - even if it’s just a routine checkup.
- Start gathering your meds today. Put them in a bag.
- Call ahead and ask: “Can I schedule a brown bag medication review?”
- Bring everything. Even the weird stuff.
- Ask: “Can I stop any of these?”
- Get a written list - and keep it in your wallet or phone.
You don’t need to be sick to do this. You don’t need to be old. You just need to be alive - and taking more than a few pills.
One bag. One hour. One chance to make your meds work for you - not against you.
What if I can’t carry all my medications to the appointment?
If mobility or strength is an issue, ask your pharmacist or home care provider to help. Many community pharmacies offer home visits for brown bag reviews. You can also take photos of each bottle - front and back - and bring the photos. But never rely only on photos. The physical bottles are needed to check labels, expiration dates, and actual contents. If you can’t get to the clinic, call ahead - most providers will work with you.
Do I need to bring my supplements and herbal remedies?
Yes. Supplements and herbs aren’t harmless. St. John’s Wort can interfere with antidepressants. Ginkgo biloba can thin your blood. Turmeric can affect blood sugar. Many doctors don’t ask about them - but they need to know. Bring every bottle, even if you think it’s “natural” or “safe.”
Will my doctor take away my medications right away?
No. Stopping a medication should never be done suddenly. Your provider will identify which ones might be unnecessary or risky, then work with you to create a safe plan to reduce or replace them. Sometimes, it’s as simple as switching to a single pill instead of two. Other times, it means a gradual taper. You’ll be involved in every decision.
Is this covered by Medicare or private insurance?
In Australia, Medicare doesn’t currently pay for brown bag reviews as a standalone service. However, many private health insurers and aged care packages include medication reviews as part of chronic disease management. In the U.S., Medicare reimburses for medication therapy management (MTM) services - which include brown bag reviews - for eligible beneficiaries. Ask your pharmacist or GP if your visit qualifies for billing under a medication review code.
Can I do this at a pharmacy instead of a doctor’s office?
Absolutely. Pharmacists are trained to do brown bag reviews - and they often have more time than doctors. Many community pharmacies in Australia now offer free or low-cost medication reviews. Just ask. You don’t need a referral. Bring your bag, and they’ll go through everything with you. It’s one of the most underused services in healthcare.
What if I don’t want to stop any of my meds?
That’s your right. The goal of the review isn’t to cut pills - it’s to make sure every pill is necessary, safe, and working for you. If you’ve been taking something for years and feel it helps, say so. Your provider will listen. But they’ll also share evidence - like side effects, risks, or alternatives - so you can make an informed choice. You’re in control. They’re just helping you see the full picture.
Final Thought: Your Pills Don’t Have to Be a Mystery
You shouldn’t have to guess what’s in your medicine cabinet. You shouldn’t have to worry that your sleep aid is making your memory worse. You shouldn’t have to take 12 pills a day because no one ever asked if you still needed them.
A brown bag review isn’t about being perfect. It’s about being safe. It’s about asking for help before something goes wrong. And it’s one of the simplest, most powerful tools we have to protect older adults - and anyone taking multiple medications.
Grab the bag. Bring the pills. Ask the questions. Your future self will thank you.
