Is It Time for a Medication Reconciliation?

Lisa L. Gill

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More than half of adult Americans regularly take at least one prescription drug, according to a recent Consumer Reports nationally representative survey. And for those who take any medication on a long-term basis, it’s a good idea to schedule a “brown bag review”—to make sure you’re taking the right medicines for your condition, and taking them correctly, says Steven Chen, Pharm.D., associate dean for clinical affairs at the University of Southern California School of Pharmacy.

And problems are all too common. For example, Consumer Reports recently asked Chen to review the medications taken by 20 consumers who had shared their prescription lists with us. He found problems in 18 of those, including one person taking a combination of blood-pressure drugs that could cause potassium levels to spike and trigger dangerous heartbeat abnormalities, and another’s mix of a blood thinner, a pain reliever, and baby aspirin that could cause stomach bleeding.

This Monday, Oct. 21, is National Check Your Meds Day, a chance to catch those sorts of problems. Ask your local pharmacy whether it is participating. Even if it’s not, most pharmacists are willing to sit down with you for a 15-minute consultation to look over your medication list. Some insurance plans might even pay for a longer consultation, though often we’ve found that it’s free to a consumer.

Are you a good candidate? If even one of the six questions below describes your drug regimen, make an appointment to see your doctor or pharmacist.

Good to know: Asking whether there are meds you can stop taking could result in at least one less prescription, according to a previous nationally representative CR survey.

1. You receive prescriptions from multiple physicians. A drug review is a good idea even if you have just one physician. But the more doctors you see, the greater the risk of miscommunication and duplicate drugs. So designate one—usually your primary care doctor—to oversee all your meds.

2. You regularly take over-the-counter drugs or dietary supplements, including CBD (cannabidiol). They can pose risks even though they don’t require a prescription. So make sure you tell your doctor and pharmacist about them, including pills, liquids, drops, and ointments.

3. You take more than one drug to treat a health problem. That’s sometimes necessary to control your condition, but it can also be a red flag you’re taking a drug you don’t need.

4. Do you need a drug to control the side effects of another? For example, do you take a laxative to ease constipation caused by an opioid? That, too, can be okay if it makes it possible for you to take a drug you require. But check to see whether you can ease side effects by lowering the dose, switching to another drug, or trying lifestyle changes instead.

5. Have you been taking your medication for more than three months? Many conditions, such as diabetes and heart disease, can require drugs for a lifetime. But for some problems, people stay on drugs longer than necessary.

6. Your meds are unaffordable. Previous CR surveys and a recent physician survey published in the Annals of Internal Medicine have found that doctors might not always consider the cost of drugs they prescribe. Don’t hesitate to ask about less expensive but equally effective alternatives, including generic versions.



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