One letter to the doctor: 29.9% against 70.8% on unsuitable prescriptions
What happened
A trial published today tested a simple idea: what happens if a pharmacist goes through every single medicine an older person with cancer is taking, and then writes to their doctor about it? The answer, it turns out, is quite a lot. The study appears in the Journal of Internal Medicine on 23 September 2026 and was run by researchers at the German Cancer Research Center. It involved 443 people aged 65 and over who were having cancer rehabilitation care. Everyone in the study was regularly taking five or more different medicines. Doctors call that polypharmacy, and it is very common in older age. The participants were split at random into two groups. One group carried on with usual care. For the other group, a pharmacist carried out a full review of every medicine, then sent an advisory letter setting out the findings to the person's doctor. The differences were large. Unsuitable prescriptions were found in 29.9% of the review group, against 70.8% of the usual care group. Medicines being overused: 34.2% against 64.1%. Medicines being underused, meaning something helpful was missing: 44.9% against 73.2%. The reviews also picked up 337 missing vaccinations across the group, covering flu, pneumonia, COVID-19 and shingles. "The pharmacist-led comprehensive medication review to counsel physicians in oncological rehabilitation wards was highly feasible and substantially improved the medication quality of older cancer patients with polypharmacy," said Ben Schöttker of the German Cancer Research Center.
Why this matters
Taking a lot of medicines is not unusual, and it is not a sign that anything has gone wrong. People pick up conditions over a lifetime, and each one is treated properly. The trouble is that medicine lists grow at the edges. A tablet is started in hospital and never stopped. A dose fits a body that has since changed. Two drugs that are fine on their own work against each other when taken together. Nobody makes a mistake. The list simply drifts. When somebody is also being treated for cancer, that drift matters more. Cancer treatment is demanding, side effects stack up, and it becomes harder to tell whether a new symptom is the illness, the treatment or an old tablet that is no longer helping. What this trial shows is that the drift is fixable, and that fixing it does not need new technology or new money. It needs somebody whose job is to look at the whole list at once. The missing vaccinations point is worth pausing on too. Three hundred and thirty-seven gaps were found in a group of just a few hundred people. Those are ordinary, protective jabs that simply fell through the cracks while everyone concentrated on the cancer.
What the evidence actually says
This was a randomised controlled trial, which is the strongest everyday design in medical research. Splitting people at random means the two groups should be alike, so differences at the end are more likely to come from the thing being tested. That is a real strength here, and the gaps between the groups were wide rather than marginal. There are limits, and it is worth being straight about them. The study measured the quality of prescribing. It did not report that people lived longer or felt better as a direct result. Better prescribing is very likely to help, but that is a reasonable expectation rather than something this trial proved. The setting was German cancer rehabilitation wards. UK services are organised differently, so the exact numbers would not transfer unchanged. Structured medication reviews already exist in the NHS, in GP practices and in community pharmacy. And the intervention was advice, not instruction. The pharmacist wrote to the doctor. The doctor decided. That is how it should work, and it is part of why this approach is realistic rather than disruptive. What the trial establishes well is that the reviews were practical to run and that they found a great deal worth finding.
Qurexa perspective
This is close to our own work, so we will be careful not to overclaim. Qurexa supports medication adherence alongside prescription delivery. In practice, that often means helping somebody keep track of a list that has grown longer than anyone intended, and making sure what arrives at the door matches what the person is actually meant to be taking. We do not run clinical medication reviews, and this article is not an advert for one. What we would say is that the NHS already offers structured medication reviews, and that a great many people who qualify have never been offered one or have forgotten it exists. If you or a relative is taking several medicines, asking your GP practice or community pharmacy about a review is free, and this trial suggests it is likely to be worth the ask.
Practical advice
If you or someone you care for takes several medicines, here are some things worth doing. - Keep one up-to-date list. Every tablet, inhaler, patch, cream, eye drop and injection, plus anything bought over the counter and any supplements. Keep it in one place. - Take that list to every appointment, including hospital ones. Different services do not always see the same record. - Ask your GP practice or pharmacy about a structured medication review, especially if you take five or more medicines. You are entitled to ask. - Ask a simple question about each item: what is this for, and does it still need to be there? A good clinician will welcome it. - Do not stop anything on your own. Some medicines need to be reduced slowly. - Mention new symptoms clearly, including tiredness, dizziness, falls and confusion. These are often medicine-related and often dismissed as ageing. - Check your vaccinations at the same time. This trial found hundreds of missed jabs, simply because nobody looked.
What to know
In a randomised trial of 443 people aged 65 and over who were having cancer rehabilitation and taking at least five medicines, a pharmacist-led review sent as advice to their doctor cut unsuitable prescribing from 70.8% to 29.9%. Overuse fell from 64.1% to 34.2%, and gaps where a helpful medicine was missing fell from 73.2% to 44.9%. The reviews also found 337 missing vaccinations. The trial measured prescribing quality rather than survival or wellbeing, and it was run in German rehabilitation wards. Even so, it is strong evidence that a careful look at the whole medicine list finds a great deal worth changing. The NHS already offers structured medication reviews. If you take several medicines, it is reasonable to ask for one. Sources: EurekAlert!/Wiley, "Can a pharmacist-led medication review improve medication use in older adults with cancer?", 23 September 2026, https://www.eurekalert.org/news-releases/1144633; Journal of Internal Medicine, "Cancer co-medication quality in older patients with polypharmacy: a large randomized trial testing a medication review versus usual care", 23 September 2026, https://doi.org/10.1111/joim.70161 This article is for general information and does not replace advice from a doctor, pharmacist, midwife or other qualified healthcare professional.
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