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Medication reconciliation: Who do I talk with to review all my meds?

Posted by gcranor @gcranor, Aug 27, 2022

Has anyone just got tired of taking so many medicines that they want to see what drug is causing other sign effects?
I am currently takeing;
Gabapentin 1800 mg daily
Metronic’s drug pump
Sumatriptan
Migraines monthly injections
Sterling
Purple pills for stomach
Tylenol 3000 mg daily

I want to stop all of them to see what I really need.

Any suggestions?

I know what the medical staff will say talk to you doctor, however I have 4 different doctors and I know they do not really read all the other doctors notes.

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Ann Shrader | @annshrader | Jun 26 6:30am
In reply to @sueinmn "I find that the older I get, and the more specialists I see, the more drugs..." + (show)
@sueinmn

I find that the older I get, and the more specialists I see, the more drugs that get prescribed - some for short term, others for longer. Right now, my records are in FIVE different, but (sometimes connected) patient portals. It is up to ME to be sure ALL of my medications and medical conditions are reported in each of those systems - but the guy who fixes my ingrown toenail doesn't really need/want to know about my glaucoma. And the doc who prescribes antibiotics for an infection doesn't have any way to know my husband had a ruptured tendon on vacation years ago, and shouldn't take certain ones.

Many are medications are beyond the scope of practice of primary care providers - for example my glaucoma eye drops, or which inhaler is best for my asthma+bronchiectasis, or whether my medications for essential tremor will interact with other meds.

Knowing and understanding all the possible interactions between medications is a full-time job. When a doc prescribes, IF the patient portal is a good one AND all of your meds and medical conditions are properly coded, the system SHOULD flag possible issues. But more than once, I have had a doc tell me to take a med my records say is bad for me.

Especially scary is when someone is hospitalized and sent home with additional medications. In my experience, hospital docs will not stop your pre-hospital meds, and the result can be overmedication or 2 medications counteracting one another. You leave with orders that say "see your primary provider within 7 days" - but often it takes much longer to get that followup appointment, or it gets lost in the shuffle of going home when you still feel ill...

So, according to my pain management doctor, if you take 5 or more prescription drugs, or are being treated for 3 or more medical conditions, you should have a complete medication reconciliation at least once - and every year or two thereafter if your meds change.

There are specialists in this field - pharmacists, RN's, Nurse Practitioners and Physician Assistants with specialized training. They sit down with you, in person or virtually, review all of your health conditions, all of your medications - prescription and over-the-counter, and all supplements you take.

Jump to this post

Hi Sue.
That is great information!
Scheduling a meeting with a pharmacist to go over the medications would be a first course of action.
Hospitalists are Internal Medicine doctors who work in a hospital setting to oversee care. It is important for medications to be managed to manage your care when you are in the hospital. The ideal situation would be to transition to homecare smoothly and that care would taken over by your PCP in a timely fashion.
If you are looking to better manage pain, there are other options. There are programs that can comprehensively go over your medications, lifestyle and goals and with medical management guide you towards better and alternative ways for you to achieve quality of life as well as better health.

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Mentor
Sue, Volunteer Mentor | @sueinmn | Jun 26 9:39am
In reply to @slkanowitz "I use an app called Drugs.com. It has everything about your meds including drug-drug interactions, contraindications..." + (show)
@slkanowitz

I use an app called Drugs.com. It has everything about your meds including drug-drug interactions, contraindications and pill ID to identify pills by picture. It’s a great resource! As a person with many ailments and on a long list of drugs, I find I have to be on top of what I am taking and why.

Jump to this post

I use it too, but found the Pharm D was even more helpful
- replaced one allergy med with another that is better with my dry eyes and glaucoma
- suggested a few changes in time of day for taking meds
- pointed out that one of my supplements had too much Vitamin B based on my blood tests

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1 reply
christine5 | @christine5 | Jun 27 9:53am

I would have whoever is prescribing you the most meds, be the one. That's how I handle it. My psychiatrist is the one who I go to when they want to put me on something new. I also keep a sheet from XL with all my meds, surgeries, conditions, and allergies. Which i give to every doctor I see. It really helps.

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andytheman | @andytheman | Jul 23 6:05am

I asked my PCP for all my doctors information and I was surprised to see that any test I’ve had and how many doctors I’ve been to was in my chart. Specialist included. Doctors are supposed to send my meds and procedures and healthcare notes to your PCP.

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catartist | @catartist | Jul 24 9:23am

My insurance secondary checks in once a year and goes over all the various meds . Blue cross blue shield. Might call-

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sbtheplumber1 | @sbtheplumber1 | Jul 27 9:56am
In reply to @sueinmn "I use it too, but found the Pharm D was even more helpful - replaced one..." + (show)
@sueinmn

I use it too, but found the Pharm D was even more helpful
- replaced one allergy med with another that is better with my dry eyes and glaucoma
- suggested a few changes in time of day for taking meds
- pointed out that one of my supplements had too much Vitamin B based on my blood tests

Jump to this post

@sueinmn with dry eyes have you been checked for Sjogren’s ?

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1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Jul 27 8:08pm
In reply to @sbtheplumber1 "@sueinmn with dry eyes have you been checked for Sjogren’s ?" + (show)
@sbtheplumber1

@sueinmn with dry eyes have you been checked for Sjogren’s ?

Jump to this post

Thanks for asking - yes, we have looked at that possibility, but that's not it.
My ophthalmologists are very careful and thorough because I have other eye issues. I feel like I would like a reservoir in my head I could fill, and just push a button when my eyes get dry. As it is, I have single use vials of drops in all my pockets, purses, car, and all over the house.

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sbtheplumber1 | @sbtheplumber1 | Jul 27 9:08pm

You might have tried them but I’ll ask have you tried gel drops at night? I’m on a prescription stop called Miebo their expensive but their oily feeling so my eyes stay lubricated better. Reason I always ask I slept with a heated ceiling fan in my bedroom and woke up from a dry eye and tore the tissue on my eye ( the week of my 40 th birthday then 2 years later my wife turned 40 her and my son were wrestling around and his toenail went across the same eye and tore her tissue , doc said he never had a husband and wife wife the same issue, I had to have surgery after being treated by 7 different doctors )

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Funcountess | @funcountess | Jul 28 9:52am

Talk to a pharmacist. Why are you taking a high amount of Tylenol?

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janie1gypsyy2001 | @janie1gypsyy2001 | Jul 28 11:59am

Do you have a pain management doctor?
Between pain management and primary care, should be able to figure out your med situation!
I would not advise going off more than one med at a time, to see and feel the changes in your body! Let them help guide you, which meds to start with, one at a time!

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