SCO Blog October 2014
“I’ve always felt mom and I have been very organized with her medications – however, with a recent fractured hip, surgery, hospitalization, and rehab stay – we are ALL confused about her medications! Does she still take the medications she was taking before the fracture AND the new medications? Please help!”
- Brian from Johns Creek
Thank you so much for your question!
Proper re-organization of her medications (or what the industry calls “reconciliation”) is crucial when a change has occurred. It is important to review all medications (at minimum) quarterly with those you provide care. This is even outside of major hospitalizations – as most people have multiple providers who all will prescribe medications and it’s easy to be quickly disorganized and unaware of changes.
Often when a patient is admitted to an inpatient setting, we might see many issues – such the client or family not providing an accurate list of home medications, current medications could change because they are not on the hospital’s formulary (list of medications they provide), medications not being appropriate for presenting critical needs, additional medications needed for new symptoms (such as pain or for infection), etc. There can be multiple changes to their medications by the hospital physicians – for very justified reasons.
When the person transfers to a rehab facility, the hospital will send their current list to the rehab center. Here, another physician might make additional changes to the medication list during their stay due to new symptoms, resolved conditions, etc.
Even under ideal circumstances, we find that there is frequently communication failure between medical providers and the client/family on general changes to medications (and sad to say) little explanation on why changes were necessary. Research shows that poor communication of medical information at transition points of care is responsible for as much as 50% of all medication errors.
It is often not until the person returns to their home setting that the previously taken medications are again compared with what is current. Often there are many changes from the original list. We recommend scheduling an appointment with the primary care physician and trusted pharmacist ASAP following discharge to review all medications, to re-clarify what is needed, and to hopefully reduce potential errors and confusion.
Wishing the best to you and yours!