What is medication reconciliation? Medication (med) reconciliation is the process of comparing the list of current medication with the list in a patient’s medical record. This includes confirming the name of medication, dosage, and frequency. It is also important to be certain one is no longer taking prescriptions that have been discontinued, as well as checking for duplications (name brands versus generic).
Michelle Costa, Chief Clinical Officer for National Health Care Associates, who has over 20 years of nursing leadership and management experience, stated the following. “Medication reconciliation can prevent an unforeseen hospitalization. If medications are taken incorrectly, this can lead to a medical episode which may result in hospitalization,” Costa said. Older adults and those with comorbidities, having multiple health conditions, are more at risk for medication errors. Side effects from taking prescriptions incorrectly will vary and may include, but not limited to, lightheadedness, falls that result in injury, or change in mental status/confusion. According to Costa, “the best way to prevent medication errors is to always bring a list of all prescriptions including over the counter medication, vitamins, and supplements (with dosage and frequency) to every primary care and specialist visit.”
If a patient has an appointment with a physician and they are experiencing new medical symptoms, by providing the doctor with a complete list of current medications, it will be easier to determine if one is having side effects from a prescribed treatment or the result of a new health issue. Cross referencing medical records at a doctor’s visit will also check for duplication of medication (two prescriptions that address the same medical condition), and this process allows physicians to see if there are medications no longer needed or require a dosage change. “Whenever possible, less is always more,” Costa added. A med list should also include any over the counter or prescribed medications one is allergic too. This information should be easily available to be provided If one needs emergency medical treatment. One’s pharmacist can also provide a current list of all prescriptions. This is one reason that the same pharmacy should be used to fill all medications so that an all-inclusive inventory can be accessed.
As stated by the Mayo Clinic, the following are questions to ask your physician or pharmacist when starting a new medication:
- What is the brand or generic name of the medication?
- What is the medication supposed to do? How long will it be until I see results?
- What is the dose? How long should I take it?
- What should I do if I miss a dose?
- What should I do if I accidentally take more than the recommended dose?
- Are there any foods, drinks, other medications, or activities I should avoid while taking this medicine?
- What are the possible side effects? What should I do if they occur?
- Will this new medication interfere with my other medications? If so, how?
Being an advocate for you or a someone you are caring for is an important part of med reconciliation. The more one understands the medications being prescribed, why it is recommended, the dosing, etc., the less likely a mistake will happen. According to the Institute for Healthcare Improvement, following the 5 R’s- right dose, right medicine, right patient, right route, right time, reduces risk of medication error. In addition to doctor’s visits, med reconciliation should be done at hospital discharge as well as discharge from a skilled nursing center.
If hospitalized for a medical event and requiring short-term rehabilitation, National Health Care Associates affiliated skilled nursing centers strive to help individuals become a better, brighter, and stronger version of themselves through an interdisciplinary team approach to care. For more information visit, www.nhca.com.
Column is written by Laura Falt, director of business development in Connecticut. Laura welcomes the opportunity to be a resource to the community on services for older adults and is often featured in local publications.