Main author: Dr Loo Say Yee, Family Medicine Specialist, Lecturer, Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM); Hospital Canselor Tuanku Muhriz UKM; committee of MySepsis.
Co-authors: Dr Khaizurin Tajul Arifin, Department of Biochemistry, Faculty of Medicine, UKM, committee of MySepsis; Professor Dr Tan Toh Leong, Consultant Emergency Physician, Faculty of Medicine, UKM; Founder and President, MySepsis
Have you ever walked out of a clinic or hospital holding a plastic bag full of medications and wondered, “Do I really need all of these?”.
Or perhaps you stared at the medications and thought, “What is this one for again?”.
You are not the only one.
Some people visit a general practitioner for something seemingly simple, such as a cough and cold, or stomach discomfort, yet leave with several different medications. For others, especially those living with long-term conditions like diabetes, high blood pressure, heart disease, or arthritis, taking multiple medications every day becomes part of daily life. Many people take five, ten, or even more pills each day (Ngcobo, 2025).
This can feel confusing, overwhelming, and worrying at times.
Despite these concerns, most patients do not ask questions. They trust their doctors, nod politely, and take the prescriptions home. Their curiosity remains unspoken. Over time, this lack of understanding may lead to missed doses, taking medications selectively, or stopping them altogether without informing the doctor.
This is not entirely the patient’s fault. Rather, it reflects how complex modern healthcare has become, where treatments are effective but often difficult to understand without a clear explanation.
Why Do Doctors Prescribe So Many Medications?
Doctors prescribe medications for different reasons, and each medicine usually has a specific role.
One medication may treat the main disease, such as high blood pressure. Another may protect an organ, such as the kidneys or the heart. Some medicines prevent complications, like strokes or heart attacks. Others reduce symptoms, such as pain, breathlessness, or acid reflux.
The longer we live, it is common to have more than one medical condition, which naturally leads to more prescriptions. This situation is known as polypharmacy, which simply means taking ≥5 medications at the same time. It is common among older patients and younger ones who are in the at-risk group (Ngcobo, 2025).
Polypharmacy is often viewed negatively, as it is associated with excessive medication use. However, it is not always bad. In many clinical situations, polypharmacy is appropriate, necessary, and even lifesaving, particularly in patients with multiple chronic conditions (Tsang et al., 2024). What should be avoided is inappropriate or unnecessary polypharmacy as it increases negative consequences for patients, including a higher risk of side effects, drug interactions, and medication-related confusion, especially if patients do not fully understand what they are taking. It also places a burden on the health care system by reducing quality of care and increasing the risk of medication errors (Halli-Tierney et al., 2019; Ngcobo, 2025).
Why Patients Often Do Not Ask Questions?
Traditionally, many patients were taught to “just follow the doctor’s instructions.” Asking questions was sometimes seen as rude, disrespectful, or a sign of mistrust. Even today, some patients worry about taking up too much of the doctor’s time (Cvetanovska et al., 2023).
Others may feel embarrassed to admit that they do not understand medical terms or instructions due to a language barrier (Cvetanovska et al., 2023).
Ironically, not asking questions often leads to medication non-adherence, which means not taking medicines as prescribed. This can include:
• Poor knowledge about illness and medication
• Forgetting doses
• Taking medicines only when symptoms appear
• Stopping medications once one “feels better”
• Avoiding medicines due to fear of side effects
• Media, internet or neighbours as a source of medication information (Kvarnstrom et al., 2018).
Local data showed that 39% of patients with chronic illnesses do not take their medications as prescribed, even in developed healthcare systems (Thew et al., 2022).
The Spectrum of Medication Use
Medication use exists on a spectrum.
At one end is non-adherence, this can lead to poor disease control, complications, hospital admissions, and even preventable deaths (Patel et al., 2025).
At the other end is polypharmacy, this can happen when:
• Multiple doctors are involved in care
• Medications are continued without review
• New drugs are added but old ones are not stopped
• Poor transitions of care (Halli-Tierney et al., 2019)
Both extremes are harmful. The goal is not about having “fewer medicines” or “more medicines,” but the right medicines for the right person.
The key issue is communication. When patients do not clarify their doubts, stop medications silently, or replace prescribed medications with supplements, doctors cannot adjust doses, change drugs, or provide reassurance. This silent gap increases health risks. Many people assume that supplements are safer because they are “natural”, but this is a common misconception. Unlike medications which are scientifically tested, regulated and prescribed based on strong evidence, supplements might not be strictly regulated, especially those which were sold in online platform.
Besides that, supplements can interact with prescribed medications (AHA, 2024). Therefore, patients should always inform their doctors about any supplements they take, even those purchased over the counter.
Patients’ Taking Control
Being an informed patient does not mean challenging your doctor, it means partnering with them.
Helpful questions include:
• What is this medication for?
• How long do I need to take it?
• What side effects should I watch for?
• Are there alternatives?
• Can any medications be stopped or simplified?
These questions are particularly important. For instance, when patients are prescribed with antibiotics, they should understand the reason of taking antibiotics and recognize that not completing the course of antibiotics can contribute to resistance.
Doctors and pharmacists should encourage such discussions. In fact, informed patients often have better health outcomes.
The Role of the Doctor
Modern medicine is shifting toward shared decision-making, where doctors and patients decide together.
A good consultation includes:
• Reviewing all current medications
• Identifying unnecessary or duplicate drugs
• Consider the cost of medications, patients’ risk factors and adjusting doses for age and kidney function
• Aligning treatment with the patient’s goals and lifestyle
• Review side effects of medications and adherence
This is especially important for older adults, who are more vulnerable to medication side effects and interactions (Halli-Tierney et al., 2019).
Conclusion
Medications are powerful tools. When used correctly, they save lives and improve quality of life. When misunderstood or misused, they can cause harm.
If you have ever felt overwhelmed by your medications, speak to your doctors. Asking questions is not a sign of distrust but a mark of responsibility.
The next time you see your doctor, bring your medication list, curiosity and concerns. Your health is more than just swallowing pills but more of understanding them.
References
AHA. (2024, January 18). Medication Interactions: Food, Supplements and Other Drugs. American Heart Association. https://www.heart.org/en/health-topics/consumer-healthcare/medication-information/medication-interactions-food-supplements-and-other-drugs
Cvetanovska, N., Jessup, R. L., Wong Shee, A., Rogers, S., & Beauchamp, A. (2023). Patients’ perspectives of factors influencing active participation in healthcare interactions: A qualitative study. Patient Education and Counseling, 114, 107808. https://doi.org/10.1016/J.PEC.2023.107808
Halli-Tierney, A. D., Scarbrough, C., & Carroll, D. (2019, July 1). Polypharmacy: Evalutaing Risks and Deprescribing. AmFamily Physician. https://www.aafp.org/pubs/afp/issues/2019/0701/p32.html#afp20190701p32-t1
Kvarnstrom, K., Airaksinen, M., & Liira, H. (2018). Barriers and facilitators to medication adherence: A qualitative study with general practitioners. BMJ Open, 8(1). https://doi.org/10.1136/bmjopen-2016-015332
Ngcobo, N. N. (2025). Polypharmacy and deprescribing among geriatric patients. In Aging and Health Research (Vol. 5, Issue 3). Elsevier B.V. https://doi.org/10.1016/j.ahr.2025.100256
Patel, S., Huang, M., & Miliara, S. (2025). Understanding Treatment Adherence in Chronic Diseases: Challenges, Consequences, and Strategies for Improvement. In Journal of Clinical Medicine (Vol. 14, Issue 17). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/jcm14176034
Thew, H. Z., Mooi, C. S., Lim, H. M., Mos, M. H. A., Tze, L. C. K., Low, K. F., Shaari, N., Lin, J. Y. S., Lee, K. W., & Ramachandran, V. (2022). Prevalence and determinants of medications non-adherence among patients with uncontrolled hypertension in primary care setting in Sarawak, Malaysia: A cross-sectional study. Malaysian Family Physician, 17(3), 128–136. https://doi.org/10.51866/oa.182
Tsang, J. Y., Sperrin, M., Blakeman, T., Payne, R. A., & Ashcroft, D. (2024). Defining, identifying and addressing problematic polypharmacy within multimorbidity in primary care: A scoping review. BMJ Open, 14(5). https://doi.org/10.1136/bmjopen-2023-081698
陈沱良医生DrSeb (drsebchannel@gmail.com) is a content creator under the Newswav Creator programme, where you get to express yourself, be a citizen journalist, and at the same time monetize your content & reach millions of users on Newswav. Log in to creator.newswav.com and become a Newswav Creator now!
The User Content (as defined on Newswav Terms of Use) above including the views expressed and media (pictures, videos, citations etc) were submitted & posted by the author. Newswav is solely an aggregation platform that hosts the User Content. If you have any questions about the content, copyright or other issues of the work, please contact creator@newswav.com.