Medication Decision Quick Tool: Benefits, Risks, Alternatives, and Review

Step 1

What is changing?

Name the actual medication decision. Medication decisions are not only about starting a new tablet.

Starting: a new medicine is being recommended. Stopping: a medicine is being stopped or deprescribed. Changing: dose, timing, route, or frequency is changing. Switching: one medicine is replacing another. Reviewing: a medicine is being continued and needs review.

Medicine / dose / decision

Current medicines / allergies / supplements to mention

Step 2

Benefit: what is it meant to do?

A medicine decision is clearer when the expected benefit is named.

I know what this medicine is for. I know what benefit is expected. I know when benefit should appear, or whether the benefit is preventive. I know what would count as not working.

Step 3

Risks, side effects, and burden

Risk is not only rare serious harm. It includes side effects, monitoring, falls, bleeding, fatigue, mood, digestion, sleep, driving, work, caring responsibilities, and daily function.

I know the common side effects. I know the serious or urgent symptoms that should not be ignored. I have checked interactions with current medicines, supplements, over-the-counter medicines, alcohol, or food where relevant. Known allergies or previous reactions have been mentioned and recorded. I have considered impact on balance, driving, mood, sleep, memory, digestion, sex, bleeding, fatigue, or daily function.

Urgent boundary: severe breathing difficulty, facial/throat swelling, collapse, severe bleeding, severe confusion, suicidal thoughts, sudden major deterioration, or another frightening reaction needs urgent help.

Step 4

Alternatives, waiting, and doing nothing

Asking about alternatives is not refusing. It helps you understand why this option has been recommended.

I know whether there are other medicine options. I know whether non-medication options are relevant. I know what happens if I wait, monitor, or do nothing for now. I know whether this is clinically urgent or whether there is time to think.

Step 5

Review and ownership

The review plan is part of the medication decision.

I know when this medicine should be reviewed. I know who owns the review: GP, specialist, pharmacist, hospital team, mental health team, or another service. I know whether blood tests, blood pressure, symptoms, side effects, mood, weight, pulse, or other monitoring is needed. I have asked, or know whether I need to ask, the pharmacist to check the full medication list. I know what would make us stop, reduce, increase, change, or continue the medicine.

Review owner / date / monitoring

Step 6

After hospital or medication changes

Check the old list against the new list. Do not guess if medicines have been started, stopped, paused, restarted, duplicated, or changed.

I know what has been started. I know what has been stopped. I know what dose or timing has changed. I know what is temporary and what should continue. I know what should not be restarted from the old medication list.

Step 7

Stopping or changing safely

Stopping is also a decision. Some medicines can cause harm if stopped suddenly.

I know whether this medicine can be stopped suddenly or needs tapering/review. I know what to do if a dose is missed. I know who to contact if the person feels worse. I will not stop, reduce, restart, combine, or change medication based only on general information.

Step 8

Repeat-back before leaving

Use this to check that the decision has landed.

Medication repeat-back: “What I understand is that this medicine is for [reason]. The expected benefit is [benefit]. The main risks or side effects are [risks]. I should take it [how]. It will be reviewed [when]. I should contact [who] if [problem]. Is that correct?”

If someone else is deciding or supporting, we have checked whether the person understands, needs support, or lacks capacity for this medication decision.

My repeat-back notes