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.

Interested in more discussions like this? Go to the Chronic Pain Support Group.

Currently in the U.S. all pharmacies and physicians can log onto your drug profile if you have electronic health insurance and your medical record is stored in an electronic medical record. The commenter was correct in it should be your family physician or primary care provider (MD, DO, PA, NP) who should review your medications with you. They can stop, start, refill, prescribe meds and no one else will do this. All providers are swamped trying to catch up with 2 years of no patients so the best time to do this is at your yearly physician exam with your PCP.

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@jenatsky

Currently in the U.S. all pharmacies and physicians can log onto your drug profile if you have electronic health insurance and your medical record is stored in an electronic medical record. The commenter was correct in it should be your family physician or primary care provider (MD, DO, PA, NP) who should review your medications with you. They can stop, start, refill, prescribe meds and no one else will do this. All providers are swamped trying to catch up with 2 years of no patients so the best time to do this is at your yearly physician exam with your PCP.

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Hmm, I was not aware of that. I know that They can log in to a profile of all opioid/controlled substances, but for other drugs I
thought it was only within your network. For example, my docs in my clinic system cannot see the meds that are prescribed to me by docs in another state - I need to self-report changes made outside our network. Same with my ortho, who is part of a different record system than my primary clinic.
Sue

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@sueinmn

Hmm, I was not aware of that. I know that They can log in to a profile of all opioid/controlled substances, but for other drugs I
thought it was only within your network. For example, my docs in my clinic system cannot see the meds that are prescribed to me by docs in another state - I need to self-report changes made outside our network. Same with my ortho, who is part of a different record system than my primary clinic.
Sue

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The purpose was to stop the over prescribing of drugs to patients who were abusers. Here in Philadelphia area whether if I go to 2 of my docs from different health systems and they see it all. Some areas may not be as connected as others I’m guessing.

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Hi,
my oldest friend has recently been diagnosed with type 2 diabetes. He is 82 with multiple serious conditions, each of which is being medicated by his GP.
His conditions include heart failure & fibrillation
Hypertension - medicated then meds withdrawn - now has low BP.
Diabetes Type 2
Claudication
Arthritis in hips' spine and ankles
Gout
Chronic Kidney Disease level 3

He is currently suffering from :
extreme pain when walking
Nausea, severe loss of appetite
Dizziness
Pains intermittently in hands, feet, knees
Insomnia
Night cramps
Anaemia

He is on a very large cocktail of meds.
His GP is treating them piecemeal with no improvement.
is there a medical specialist discipline that could take an overview of his conditions and medication ?

I'll be very grateful for any insight into this. Thanks

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@macferse

Hi,
my oldest friend has recently been diagnosed with type 2 diabetes. He is 82 with multiple serious conditions, each of which is being medicated by his GP.
His conditions include heart failure & fibrillation
Hypertension - medicated then meds withdrawn - now has low BP.
Diabetes Type 2
Claudication
Arthritis in hips' spine and ankles
Gout
Chronic Kidney Disease level 3

He is currently suffering from :
extreme pain when walking
Nausea, severe loss of appetite
Dizziness
Pains intermittently in hands, feet, knees
Insomnia
Night cramps
Anaemia

He is on a very large cocktail of meds.
His GP is treating them piecemeal with no improvement.
is there a medical specialist discipline that could take an overview of his conditions and medication ?

I'll be very grateful for any insight into this. Thanks

Jump to this post

@macferse Hi, it's really good of you to take an interest in what your friend is experiencing. Piecemeal, or what I sometimes call the "add-a-pill" practice is an unfortunate experience for too many people. I'm not sure of the cause - but I think it is partly how overwhelmed out family docs are - with too many patients, too little experienced staff, and corporate and insurance driven restrictions.

You don't say where he is located, but if there is any possibility, your should be seeing someone with advanced training in geriatric medicine, preferably a doctor of internal medicine or a specially trained nurse practitioner. As for a source for referral, I have always gotten good advice from hospital social workers or nurse navigators who spend their days connecting people to the right resources. Larger clinical practices and insurance companies sometimes have similar people on their staff. Finally, if you county or state has an "elder ombudsman" office, they can be helpful.

Does this give you a starting place? Thank you for being a caregiver to your friend - it takes a whole community to keep everyone safe and healthy.
Sue

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@macferse

Hi,
my oldest friend has recently been diagnosed with type 2 diabetes. He is 82 with multiple serious conditions, each of which is being medicated by his GP.
His conditions include heart failure & fibrillation
Hypertension - medicated then meds withdrawn - now has low BP.
Diabetes Type 2
Claudication
Arthritis in hips' spine and ankles
Gout
Chronic Kidney Disease level 3

He is currently suffering from :
extreme pain when walking
Nausea, severe loss of appetite
Dizziness
Pains intermittently in hands, feet, knees
Insomnia
Night cramps
Anaemia

He is on a very large cocktail of meds.
His GP is treating them piecemeal with no improvement.
is there a medical specialist discipline that could take an overview of his conditions and medication ?

I'll be very grateful for any insight into this. Thanks

Jump to this post

@macferse, I moved your great question to this existing discussion where @gcranor asked a similar question:
- Medication reconciliation: Who do I talk with to review all my meds? https://connect.mayoclinic.org/discussion/stop-all-medicine/

I did this so you can read the previous posts as well as connect easily with @gcranor @sueinmn @jenatsky and others.

I agree with Sue that someone with advanced training in geriatric medicine would be a great help. Your friend might also enlist the help of their local pharmacist. Pharmacists can be a very helpful addition to one's health care team.

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I have found my Pharmacist to be the best source of information about Medications. I think most Doctors skipped this class ( if there was one). If you spend a lot of money at a pharmacy, they tend to give you a (short) audience. Of course it is cheaper to buy in bulk online (so they say), but no convo then!! Best wishes1

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I’ve been considering & experiencing the exact same things! I know my dr’s don’t fully review other docs info fully. I’m in constant pain & want to figure out is it partially due to scripts for other issues. Thanks for the input. I’ll post something similar soon

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Not complaining but wondering why, and yes ANOTHER uti with visible blood, the 14 pills of Trimethoprin cost only $3.50 cents ... can barely buy a large chocolate bar for that! No, don't want to pay an arm and a leg but really, under $4 plus pharmacy dispensing fee, seems odd to me. (Canada)

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Part of your Primary care Doctors job is to keep up-to-date records of all the meds you are taken and then review them with you at least every 6 months. If for some reason they are not networked with all the other Doctor offices you can have your pharmacy print out your records. Worst case bag the bottles up and take them with you.
It's your life or the life of a loved one you are trying to help, if your current PC won't do that it's time to find a new one. Some of NP that do this for them.

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