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

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.

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.