What Is a Brown Bag Medication Review?
A brown bag medication review is a simple but powerful way to make sure you’re taking the right medicines, in the right amounts, for the right reasons. You gather every pill, capsule, liquid, cream, inhaler, vitamin, supplement, and herbal remedy you take - all of it - and put it in a brown paper bag. Then you bring it to your doctor, pharmacist, or nurse for a full checkup. No lists. No memory games. Just the real stuff, in the bag.
This isn’t just a nice idea. It’s a proven safety tool. Back in 1982, pharmacists in the U.S. started giving patients brown grocery bags to collect their meds. The name stuck. Today, it’s part of standard care for seniors and anyone on five or more medications. The goal? To catch mistakes before they hurt you.
Why This Matters: The Hidden Danger of Too Many Pills
Most people don’t realize how risky it is to take too many medicines at once. This is called polypharmacy. According to the 2023 National Poll on Healthy Aging, nearly half of all adults over 65 are taking five or more prescription drugs. Add in over-the-counter painkillers, sleep aids, heartburn meds, and supplements, and the average senior is juggling nearly seven different substances daily.
Here’s the scary part: up to 50% of medication-related problems in hospitals come from simple errors - like taking two drugs that clash, doubling up on the same medicine, or holding onto pills that no longer serve a purpose. A 2023 Home Helpers Home Care study found that in nearly 7 out of 10 brown bag reviews, providers found dangerous mistakes. One man was taking two different beta blockers - from two different doctors - and didn’t even know it. He was dizzy, tired, and falling. The review stopped the double dose. He stopped falling.
What Exactly Do You Need to Bring?
Don’t just grab your prescription bottles. Bring everything. Every single thing you put in your body on a regular basis. That includes:
- All prescription medications (pills, liquids, patches, inhalers, eye drops)
- All over-the-counter drugs (ibuprofen, antacids, cold medicine, sleep aids)
- All vitamins and minerals (even the ones you only take “sometimes”)
- All herbal supplements (turmeric, ginkgo, echinacea, fish oil)
- All topical creams or ointments used daily (like arthritis cream or steroid skin treatments)
Don’t leave anything out because you think it’s “not important.” That’s how mistakes happen. A woman brought her brown bag to a review and realized she’d been taking a daily magnesium supplement for five years - even though her doctor had stopped prescribing it. She didn’t know the difference.
Also, bring the actual bottles. Not just the pills. The labels have the name, dose, instructions, and expiration date. That’s critical. A 2023 study showed that 28% of seniors couldn’t remember the exact dose of their own blood pressure pill - but the bottle told the truth.
How to Prepare: A Step-by-Step Guide
- Set a date. Schedule a 30- to 45-minute appointment with your doctor or pharmacist. Don’t try to do this during a quick checkup. You need time.
- Gather everything. Go through every drawer, bathroom cabinet, purse, and nightstand. Look for old prescriptions, leftover antibiotics, or samples you never used. Put them all in a brown paper bag - or any bag, really. The color doesn’t matter. The completeness does.
- Write down your questions. Are you confused about why you’re taking something? Are you having side effects? Do you feel like you’re on too many pills? Write them down. Bring them with you.
- Bring a family member. If you’re over 65 or have memory issues, bring someone who helps you manage your meds. They’ll remember things you forget.
- Don’t skip your supplements. Many people think herbs and vitamins are “safe.” They’re not. St. John’s wort can interfere with antidepressants. Garlic pills can thin your blood. Your provider needs to know.
What Happens During the Review?
The provider will lay everything out on the table. They’ll compare your bag to your medical records. They’ll check for:
- Duplicates - two different prescriptions for the same drug
- Drug interactions - combinations that can cause dizziness, falls, kidney damage, or bleeding
- Expired meds - pills you’ve been holding onto for years
- Unnecessary drugs - something you were prescribed for a short-term issue that never got stopped
- Incorrect doses - taking too much or too little
- Lack of purpose - a pill you can’t explain why you’re taking
They’ll ask you questions like: “When was the last time you took this?” “Do you feel better since you started this?” “Do you ever skip doses?”
This isn’t a judgment. It’s a cleanup. In the Bexley and Greenwich pilot study, nearly two-thirds of seniors had at least one unnecessary medication removed after a review. One woman stopped taking four pills she didn’t need - and felt more energy than she had in years.
Why This Works Better Than a List
Most people try to write down their meds. But studies show that doesn’t work. The Agency for Healthcare Research and Quality found that when patients tried to list their medications from memory, only 1 or 2 out of every 10 lists were accurate. That’s an 80-87% error rate.
Why? Memory fades. Labels get lost. Pills get moved around. You forget you took that extra painkiller last night. You think your ginkgo supplement is “just herbal,” so you don’t mention it.
A brown bag review cuts through all that. It’s physical. It’s real. It’s 92-95% accurate, according to research. That’s the difference between guessing and knowing.
Who Needs This Most?
This isn’t for everyone - but it’s critical for some.
You need a brown bag review if:
- You’re 65 or older
- You take five or more medications daily
- You’ve been hospitalized in the past year
- You’ve had a fall or balance problems
- You’ve had side effects like confusion, dizziness, or nausea
- You see more than one doctor
- You get prescriptions from different pharmacies
According to the National Council on Patient Information and Education, adults over 65 average 4.7 prescriptions and 1.9 over-the-counter drugs. That’s a lot of room for error. And it’s exactly why Kaiser Permanente and Mayo Clinic now require brown bag reviews for all patients over 65 during their annual wellness visit.
Common Problems - And How to Fix Them
Even with good intentions, people run into roadblocks.
Problem 1: “I forgot my meds at home.”
Solution: Ask your provider if they can reschedule. If you can’t make it, ask for a home visit or a phone consultation with your pharmacist.
Problem 2: “I’m embarrassed. I have so many pills.”
Solution: This is normal. Most people have more than they think. Providers see this every day. They’re not judging - they’re helping. One nurse on Reddit shared: “I had a patient who was taking three sedatives. She didn’t know. We stopped two. She slept better and didn’t fall again.”
Problem 3: “I don’t know what half of these are for.”
Solution: That’s why you’re there. Write down the names and bring them. The provider will explain each one. If they can’t, they’ll question whether it’s still needed.
Problem 4: “It’s too much work.”
Solution: You don’t have to do it alone. Ask a family member, neighbor, or home care worker to help you gather everything. Many pharmacies now offer free brown bag review days - just call and ask.
What Happens After the Review?
You’ll leave with a new, simpler plan. That might mean:
- Stopping one or more pills
- Changing a dose
- Switching to a safer alternative
- Getting rid of expired meds
- Getting a new pill organizer
- Setting up reminders on your phone
Your provider will give you a written update. Keep it. Show it to your pharmacist. Put it in your wallet.
Follow-up matters. Studies show that patients who get a follow-up call within two weeks after a review are 50% more likely to stick to their new plan.
What’s New: Technology and the Future
Some pharmacies now use apps that let you snap a photo of your pills. The app identifies them and checks for interactions. That’s helpful - but it doesn’t replace the brown bag.
Why? Because many dangerous meds aren’t in electronic records. A 2024 study found that 41% of critical errors involved pills that were never documented anywhere - just kept in a drawer.
Technology can help, but the physical bag still wins. The future? A hybrid: you bring your bag, and your pharmacist scans the pills to cross-check with your records. That’s what CVS Health is testing now - and it’s cutting errors even further.
Final Thought: This Isn’t Just About Pills. It’s About Safety.
Medication errors are one of the leading causes of hospital stays for older adults. In 2022, the Institute for Safe Medication Practices estimated that bad drug reactions cost the U.S. system $528 billion a year. Most of those are preventable.
A brown bag review takes 45 minutes. It might feel awkward. It might feel like extra work. But it could save your life - or at least keep you out of the hospital.
Don’t wait until you fall. Don’t wait until you feel sick. Don’t wait until your doctor asks. Take the bag. Gather your pills. Make the appointment. Your future self will thank you.
Do I need to bring my supplements and vitamins to a brown bag review?
Yes. Vitamins, minerals, herbal supplements, and even fish oil count. Many of these can interact with prescription drugs. For example, St. John’s wort can reduce the effectiveness of blood thinners and antidepressants. Garlic supplements can increase bleeding risk. Your provider needs to know everything you take - even if you think it’s harmless.
Can I just bring a list instead of the actual pills?
No. Lists are often wrong. Studies show that when people write down their medications from memory, 80-87% of the time they miss something or get it wrong. The brown bag review works because it uses the real bottles - with names, doses, and expiration dates. That’s the only way to catch hidden mistakes.
How often should I have a brown bag medication review?
At least once a year. If you’re over 65, take five or more medications, or have recently been hospitalized, you should have one every six months. Also, schedule one after any major change - like a new diagnosis, hospital stay, or new doctor.
Will my doctor think I’m taking too many pills?
No. Doctors expect this. They know how common polypharmacy is. This isn’t about blame - it’s about safety. Many providers actually encourage patients to bring their bags. Some clinics even give out free brown bags at the front desk to make it easier.
Is this covered by insurance?
Yes, for Medicare beneficiaries. Since 2023, Medicare Advantage plans are required to cover annual medication reviews, and many reimburse providers $45-$50 per review. Medicare’s Annual Wellness Visit now includes a mandatory medication reconciliation - and a brown bag review is the gold standard for meeting that requirement.
What if I can’t get to the appointment?
Ask about home visits or telehealth options. Some pharmacies and home care agencies offer in-home brown bag reviews. You can also call your pharmacist - many will walk you through the process over the phone and help you sort your meds. The goal is safety, not perfect attendance.
Next Steps: What to Do Today
Don’t wait. Here’s what to do right now:
- Find a brown paper bag - or any bag.
- Go through every drawer, cabinet, and purse in your home.
- Collect every pill, bottle, and supplement you take.
- Call your doctor or pharmacist and ask: “Can I schedule a brown bag medication review?”
- Bring the bag to your next appointment.
That’s it. No fancy tools. No apps. Just your meds - and your safety.
Elizabeth Choi
November 27, 2025 AT 16:04Also found three expired antibiotics from 2019. Threw them all in the disposal bin at the pharmacy. No more junk drawers.