Organizing Your Medication List

Why Is This Important?

 What You May Consider

VIDEO

 

    Here are a few things to consider when making your medication list. The very first to consider is patient safety. Safely taking medications is of utmost importance and should always be considered.

     If you have several physicians or healthcare professionals treating you, they do not necessarily communicate to each other regarding updating your medication list. This is up to the patient/family to update each healthcare professional or facility. Normally, this occurs when the visit occurs-they will ask for any updates or lists.

     This is especially true in a facility like a hospital. The hospital will ask you for a list of medications you are currently taking. Typically, at discharge, all new medications will be added to your original list-unless some were discontinued.

A Complete Picture of your Medications   Your list is Valuable Information

     Your medication list is valuable information. When you provide an up-to-date list of current medications to a healthcare professional, they now have a more complete picture of you. Decisions can be made with this information. This is one of many reasons, your list should be accurate.

      This can affect how new medications might be ordered from that healthcare professional. For example, with this information, they can decide how the new prescription might interact with a medication already taking. They might also decide against any duplication of medications. This is just a few.

       Maybe you are having blood tests done, and your healthcare professional may need to know your medication list because some medications can affect lab results

    Emergency Room: The last thing anyone wants to do is try to remember a long list of items when not feeling well. This can be especially daunting in an emergency. Valuable time is saved when a complete and accurate list is provided vs the hospital staff trying to figure out what you are taking.

-Pill organizer-A pill organizer is not a replacement for an accurate list. 

Here is an Example of Categories of Information for a medication list 

1. Name of the Medication: The chemical name and the proprietary “Brand” name is listed on the label of every medication. 

2. Dosage: If you see the directions that state “take one tablet every 8 hours”-this is not the dosage, it is considered “directions for use” You’ll find the “dosage” near the name of the medication. The dosage has an abbreviation next to it: For example: “mg” or “mcg”, for example. 

3. Directions for Use: How often to take this medication.

4. Start Date: This can be useful information. For example, when taking an antibiotic, it is helpful to know when the medication was started and stopped.

5. Pharmacy: the name of the pharmacy and phone number where it was filled.

6. Notes: any special notes should be added to the list

7. Vitamins and Supplements: it is important to list any medications, supplements and over the counter medications, especially if taken on a regular basis.

      Know how long you are supposed to take the medication. 

     For example, an antibiotic is ordered for a specific time frame, then you are supposed to “run out” because you have finished the course of treatment. Other medications are taken on a more long-term or short-term basis. It depends on what the medication is for and why you are taking it. This should be discussed with your clinician at the time it was ordered. 

      Special directions: this can be overlooked. Sometimes, in the rush during an appointment, patients can forget what the doctor/clinician told them about any special directions. You can find this information on the bottle or the detailed medication printout that came with your medication when you filled it. Discuss with your clinician and or pharmacists.

      Special Preparation: sometimes people can’t take large pills, so taking a liquid can be requested-NOT all medications come in a liquid form, so make sure to discuss with your healthcare practitioner-prior to getting medication filled. This is especially true if you have an ileostomy. 

      Word of caution: if you take a particular medication on a regular basis, it is always a good idea to look at the pills (preferably before you leave pharmacy) to check your medication for consistency-The color and shape the same as usual? Or is something off? If something is off, contact pharmacist immediately. This can be especially tricky when taking generic drugs. Bottom line, be sure to check, ask questions, and if anything is off, ask your pharmacist. Medications by the same name can come in different dosages. For example, some medication tablets with the same name come in different dosages indicated with a different color. 

      How long will you be taking the medication? This should be discussed with the person who prescribed your medication.

      Why are you taking this medication: it was prescribed for what reason?

      Medications can be dangerous, especially if they are not taken in the manner in which they were intended. Sometimes people have a symptom they don’t care for, so they stop taking the medication as prescribed. It is highly recommended that anytime for any reason, you have an issue with a medication, contact the clinician who prescribed it and describe and discuss the issue.  

      Patients sometimes take medications from several different prescribers-or doctors/clinicians. This can be further complicated when a person is discharged from a hospital with prescriptions for new medications. It is common practice to “reconcile” (update) a patient’s medication list anytime one is admitted/treated at a hospital. Meaning, your medication list will be added to your new list of medications prescribed while in the hospital, giving you one complete list at discharge. 

Here is a Scenario:

            Mrs. Jones was admitted to a hospital for surgery. It was determined that the best discharge plan for Mrs. Jones was to be discharged to a rehabilitation in- patient facility for further rehabilitation and strength training. 

          >The medication list she provided when admitted to the hospital: 

Were all of her “normal” medications continued as usual, when she was in the hospital? Or were some medications stopped/discontinued? 

Why This Is Important

     > If Mrs. Jones was “supposed” to take a particular medication that was not continued while in the hospital, there is a high probability that this will continue when she is transferred to the new facility. A hospital will send a medication list along with admission information so that Mrs. Jones can be admitted to the new facility.     

This should be a cause for inquiry!

     There are endless reasons why medications are added and discontinued. Need to inquire as to why.

The Take Home Message

         This is when knowing one’s medication regimen is very important.  Mrs. Jones noticed she wasn’t getting one of her medications she normally takes at home. What Mrs. Jones found, through asking her doctor at the new facility was, one medication she normally took at home was left off the list. After a discussion with her doctor at the new facility, Mrs. Jones was reassured that her medication would indeed be added to her medication regimen at the new facility.

     This scenario is more common than one might think. In fact, it is when patients are transferred that information regarding one’s medication is of particular interest. In other words, be on the lookout for any discrepancies.  

      The case for keeping an updated list with you anytime you are interacting with a clinician, hospital, doctor, or clinic. Keeping track of it all, can be challenging but extremely important. You can expect that with any interaction with a healthcare professional or facility, you will be asked to provide a list. Accuracy is important.

      Who’s who in the medication picture: You have interacted with a person that can be identified as a “licensed clinician” -this person has a license to prescribe medications and treatments.

 Common identification of these people, that are licensed to prescribe medications specifically are: Doctor/physician; Nurse Practitioner-specially trained advanced practice nurse that has been trained and licensed to prescribe medications and treatments; PA-physician’s assistants-these are people who have specialty training and licensure to prescribe medications and treatments. It is always a good idea to know exactly what the credentials are of the person that is prescribing your medication.

 Pharmacists: pharmacists are highly trained and licensed to “dispense” medication. Typically, a person in a pharmacy prepares your medication, then a pharmacist will check to make sure the medication, directions for use, dosage, etc. are correct before the medication is given to the patient. When you interact with someone on the phone, always ask their name and title because asking the wrong person about your medications issues is never a good idea. Be especially weary when discussing medication issue over the phone.

 Pharmacy by mail: Typically, a “licensed practitioner” has given the pharmacy, regardless of whether it is an actual building or mail order, a prescription to be filled. Same rules apply -know why you are taking the medication, how you are supposed to be taking it, how long and any precautions or special directions. 

      Allergies: The term “allergy” is a more complicated and confusing term than most people realize. It is a very general term defined differently depending on who’s using it. For example, a patient may have an upset stomach with diarrhea when taking a medication. The patient may think they have had “an allergic reaction”. The doctor on the other hand, knows that the medication can cause these symptoms, and does not deem it an allergic reaction, but may classify it as a “side effect”.

      Adverse Reaction vs Allergic Reaction: The published medication description of a particular medication may describe some symptoms as “adverse reactions” or “side effects”. These side effects and or adverse reactions can be mild to severe or debilitating-but not considered an “allergic reaction”. What’s important: when a medication is prescribed, any side effects should be explained to you by the person prescribing the medication. It goes along with “what to expect” and any special directions associated with taking the medicine. If the person taking the medication experiences anything other than what is expected, they should call the person prescribing that medication. This can get tricky if the medication was prescribed at the hospital, in which case, your “regular” primary care practitioner should be contacted. This is just another reason for why you should have a “regular” or “primary care clinician/doctor.  

A Word of Caution: Regarding a “pill organizer”:

      This is a type of pill reminder system people use at home. Generally, it’s a box with little compartments noted with each day of a week. It’s used by taking the medication (usually pills or capsules) out of the bottle and placing in the appropriate compartment. It’s primarily used as a reminder so that one can tell if the medication for the day was taken. This activity comes with these reminders. 

     First, make sure you are placing the correct medication in the correct compartment. Be especially careful with medication you are unfamiliar with. Making sure it’s the correct medicine is important. Making sure it is taken correctly is also important. Once you have taken a medication out of a bottle, it’s highly recommended that you be able to recognize that particular medication by the color, size, and shape. This is because, once it’s taken out the bottle, and no medication label attached to it, it will be difficult to tell if the medications are “dispensed” into the pill organizer correctly. Highly recommended that you have someone you trust to aid you in using these types of devices, even double checking for you. Convenience is nice, safety is imperative. Keeping the bottles your medications came in will also aid you because you can always refer to the bottle and printed hand out for reminder on how to take.       

 Taking your Actual Medications with You to… 

       The purpose of the medication list is so that you will have a complete up-to-date list of current medications. However, patients do arrive with their actual medication bottles in hand. Although this is not the most efficient or safe thing to do, it is a common practice.

    For Consideration

     >Some medications are sensitive to temperature and some even to light. So, transporting them in less than desirable conditions is not recommended.                                         >
     >Collecting all the medications you are taking. It is relatively easy to forget a pill bottle, especially if they are in different locations in the house.                                                          
     >In an emergency, you may not be the one assigned to “collecting” all those medications to take with you to the hospital-some can be left out.                                                             >Losing the medications themselves. In a hospital, expect to be transported from department to department, room to room. This is very common. Keeping your medication containers/bottles etc. with you only increases the chance for loss.

SUMMARY

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     One major goal of The Patient University is to give patients and their families information regarding healthcare navigation. Navigation in this respect is learning how medication lists can aid in keeping you/your loved ones safe. The take-home message is the more involved and knowledgeable one is about one’s own healthcare, the safer one becomes. Medication safety is an integral part of this safety picture. 

Thank you for participating, and good luck. Please feel free to contact us with any input, comments and questions at

thepatientuniversity@gmail.com

  RESOURCES

  Medication Safety Basics | Medication Safety Program | CDC

 Medication Administration Safety – Patient Safety and Quality – NCBI Bookshelf (nih.gov)  

The Patient University: free initial phone consultation to discuss approaches to making your medication list.