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

Hi Sam, Lorie's advice about making an appointment with the pharmacist is great, but so is her observation that they are overwhelmed.
If you cannot get an appointment with your local pharmacist, some large clinical practices have a specialized pharmacist on staff or available by referral to do this as well. You may need a referral to get an appointment.
Make sure the appointment includes a personal interview, either in person or by phone, as there will be questions. Be prepared to be asked a lot of questions about diet and lifestyle as well, as these can affect how your body metabolizes medications and supplements.
It might take a little effort, but it is worthwhile if you are on a lot of medications, or if you feel some of your meds are making you feel worse.
Sue

Hi sue, thank you for the good advice about a pharmacist. Yes it would take awhile to get an appointment with one. I will try and if not, see if there is an assistant I can talk to.
Thanks!

I have a pharmacy that I have used for the past 5yrs. My disappointment comes from my pharmacists NOT telling me a drug I have been on for years was causing my falls, dizziness, & brain fog. My Mental health Dr had to be the one to tell me that the drug I had been on for yrs was causing the problem!!! No one else looked at the list of drugs I was on to see if there might have been a correlation. I am on a lesser dose & haven't fallen since. I could have saved an MRI, X-Rays, bloodwork seeming a Neurologist, & several other tests to verify the cause of my dizziness.

This is very good advice Lori, especially when you receive a prescription that will be filled by a specialty pharmacy or compounding pharmacy. I went through a full-on check of every medication, including OTC products. The lady was extremely thorough, asked a lot of questions and was looking for any history that might indicate a presenting issue. The new medication is a twice-monthly injection so she was very interested in knowing the when and why......as well as how long I had been taking every medication.

At first I was a bit annoyed......like I have been taking Losartan without any dosage change for about 15 years. However, before my recent surgery, I had to briefly stop the Losartan for a good reason. So......I am no longer irritated and begging for forgiveness. Just because I am such an old duck, doesn't mean I know everything.

I also received several pages of information about the new medication. My local pharmacist puts a red dot on any new medication which means he wants to talk to me about it when I come in to pick it up. I always wondered why some folks had red dots on the paperwork.

Still learning.
Chris

Yes pharmacists are over whelmed with prescriptions and questions. Good advice to try and make an appointment, even if telephone. I do have a source of a anxiety pharmacist. Not sure if she could help with different meds though.

You can request a pharmacist appointment in your doctor's office and they will go over all your medication with you.

That is a great question, one I’ve not found an answer to. Almost every dr I see, pretty much says the same thing, “wow, you’re on a lot of meds”, then prescribed more, without ever looking to
See if they’ll interact with any I’m already taking. I generally look them up myself or talk to my pharmacists who are awesome, before filling. They advise if there’s a problem or recommend about how to take. I do wish I could see a dr who would look at the “whole body” including my meds. I’ve tried a couple internal medicine docs but both said they wouldn’t touch anything my specialists were handling, which is basically 75% of my body!

Your primary care Doctor should go over everything with you. It's one of the reason they are your first visit for anything new.

Theoretically it is true that the primary should be going over meds, but if specialists prescribe, most PCP's assume they know more about what they are doing than the primary - that's why you were referred. And even if willing, they are SWAMPED these days, allowed only 15-30 minutes per patient visit - including paperwork - to do their job.

A Pharmacist is immersed in the wild and sometimes scary world of how drugs work (or don't) together, so are often better qualified to make the analysis. There are also nurses, advanced nurse practitioners and physician assistants who have advanced training in medication management. The complexity of the issues is why med reconciliation needs to be undertaken by someone other than the PCP in people with multiple providers and multiple medical conditions.

Finally, the complexity of medication management and interactions is why people need to use one pharmacy, or at least one pharmacy network for all meds - their systems are now designed to "flag" possible interactions between current drugs. They can be the first line of defense against inadvertant interactions.

Sue

If you cannot find an MD that is also a pharmacologistt, then suggest your family doctor should be your first stop.