Prescription medications, over-the-counter drugs, herbal supplements, and vitamins are all used to treat health issues, but many times, patients are not openly communicating with their primary care provider about all the different pills they are taking. Patients may assume their doctor is aware of medications prescribed by specialists or other providers, but that’s not always the case.
What is a medication review and does my care recipient need one?
A medication review (aka a medication reconciliation) is the process of comparing a patient’s medication orders to the medications the patient is taking. Benefits include:
- Catch duplications of medications, supplements, or prescriptions that treat the same symptoms.
- Catch dosing errors and discuss proper administration of your medications.
- Avoid adverse drug interactions.
- Catch medical errors that could result from an incomplete understanding of past and present medical treatment.
Consistent review of medications will help ensure your care recipient and their primary care provider are on the same page and health needs are being addressed in the best possible way.
A typical medication review has five steps:
- list the patient’s current medications
- A formal and comprehensive list of medications should include all prescription medications, herbal supplements, vitamins, nutritional supplements, over-the-counter drugs, vaccines, diagnostic and contrast agents, radioactive medications, parenteral nutrition, blood derivatives, and intravenous solutions.
- list the medications currently needed
- compare the two lists
- make a new list based on the comparison
- communicate the new list to the patient and caregivers
Who can conduct a medication review?
You can request a medication review from the Primary Care Physician; however, the patient’s pharmacist can also assist and is a good source of information. Be prepared with specific questions as most Pharmacists are very busy; Pharmacists want to help and are worth your patience.
If your care recipient doesn’t have a current medication list, you can bring the physical bottles to the reconciliation appointment. This method is helpful as there is less chance that a medication, supplement, or prescription is forgotten or overlooked. When you bring in bottles, be sure they are all tightly closed and carried in a safe bag so none are lost or misplaced.
When should a medication review be conducted?
Consider requesting a medication review at during the patient’s annual physical exam and also at every transition of care in which new medications are ordered or existing orders are rewritten. Transitions in care include changes in setting, service, practitioner, or level of care.
NOTE: Many medication errors happen during hospital stays.
It’s estimated 10 percent of patients will experience a medication error when hospitalized. According to the Institute of Medicine’s Preventing Medication Errors report, the average hospitalized patient is subject to at least one medication error per day. This confirms previous research findings that medication errors represent the most common patient safety error. More than 40 percent of medication errors are believed to result from inadequate reconciliation in handoffs during admission, transfer, and discharge of patients. Of these errors, about 20 percent are believed to result in harm. Many of these errors would be averted if medication reconciliation processes were in place.
(Source: https://www.ncbi.nlm.nih.gov/books/NBK2648/)
Who’s responsibility is it to get a medication Review?
The responsibility of managing medications is equally shared between a patient and their health care provider. While the provider is responsible for writing prescriptions and educating patients, it is ultimately up to the patient to follow the provider’s recommendations.
Sources: the National Library of Medicine.
We hope this information is helpful to you in the important work you do as a family caregiver.
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