Polypharmacy guidance: Appropriate prescribing making medicines safe, effective and sustainable 2026-2029
The person-centred 7-Steps review process starts by matching therapeutic objectives to current life priorities with the individual. This is illustrated in the figure below. This initial discussion guides decision-making in subsequent steps that consider medication need, effectiveness, and safety before a therapeutic plan and follow-up strategy are agreed upon.
Applying the 7-Steps as part of a holistic medication review has the potential to address all six dimensions of quality in health care: efficacy, safety, efficiency, timeliness, equity, and acceptability.25
Although the 7-Steps approach was primarily designed to be applied at the point of medication review to correct inappropriate prescribing, its principles may equally be applied when initiating new medicines, to prevent inappropriate prescribing, or when a patient moves across transitions of care. This may result in reducing the dose or stopping a medication completely, although this should not be the primary objective of a medication review. Addressing unmet needs may include starting new medications.
The 7-Steps medicine review process
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The actions undertaken in each step are summarised below and medicines that may be relevant to review at each step are highlighted.
More detail in application of the 7-Steps can be found in the case study examples.