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Medication reconciliation: tracking your medications

Updated: Oct 26, 2021

Why do they ask me what I'm taking every time I go to my doctor's office?

That is called medication reconciliation. Individuals should understand what is meant to be an ongoing medication and what is a time-limited prescription. Antibiotics and pain medication are usually time-limited whereas most other medications are meant to be ongoing, at least until further evaluation.

Patients given no refills or 2, 5,or 11 refills for 3, 6, or 12 months may infer erroneously that they should discontinue the drug when the prescription runs out. On the other hand, the physician may intend to discontinue a drug, but the pharmacy sends a refill request by fax that gets refilled automatically. Patients calling to inquire whether they should continue a medication or not may be directed by the phone tree to call their pharmacy to initiate a refill request. This can lead the patient to take a medication perpetually that was meant to be discontinued. Everything is handled electronically, and no one thinks about it. Dose changes also can lead to confusion.

The coders of modern electronic medical records seem to think that a new prescription is written every time a dose is changed, but that is simply wasteful. The clumsy handling of medication lists by electronic records systems often provides more confusion than clarity. Medications fall off the list prematurely or persist long after the physician discontinued them. Duplicates abound. Dose changes are not captured. Because of the confusion generated by electronic records and by rotating staff in big offices or hospitals, the best source of knowledge about what medication and what dose the patient should be or is taking is the patient herself. Commonly, when I ask a patient what medications or what dose they are taking, they point and say, "I don't know, it's in the computer." I respond that it does not matter what the computer says, the only truth is what the patient is actually putting in her mouth.

A drug that you are not taking cannot be causing your symptoms or helping control them. A drug that you are taking that I don't know about could be causing you harm that we are unable to address. For your safety, you must know your medication list, the dosage, and your allergies. If you do not have it in your head, write it down!

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