Medication Reconciliation Steps
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Transcript of Medication Reconciliation Steps
Continuity of CarePatients 65 years and older have multiple medical problems, are
on multiple medications, and are seen by multiple providers. Having a primary care physician, communicating among all providers, and
reconciling medications are all essential for quality patient care.
Ask the patient…
1. What are the names of the medications (including OTC, vitamins and herbal supplements) you are currently taking?
2. How do you take your medications and how much have you been taking?
3. Do you understand what the medication is for?
4. Where do you get your prescriptions filled?
MD action…
1. Compare home list to the list in the patient’s chart.
2. Ensure dose and frequency are the same and there is a clear indication for every medication.
3. If patient doesn’t understand what meds are for, educate using plain, non-medical language; speak slowly; break down information into short statements.
4. Call the pharmacy if there is any discrepancy between the patients’ reported meds and your list. Rectify in the patient’s chart.
Medication Reconciliation Steps
References: Wenger, N.S. and R.T. Young (2007) “Quality Indicators for Continuity and Coordination of Care in Vulnerable Elders.” JAGS 55:S285-292.Varkey, P. et al (2007) “Improving Medication Reconciliation in the Outpatient Setting.” Jt. Comm J on Quality & Patient Safety 33:5.
Funding provided by D.W. Reynolds Foundation
Obtain medication list from patient
Obtain medical record medication and
problem list
Identify discrepancies
Include updated list in clinic note
Give patient a copy of updated
medication list
Document updatedmedication list
Optimize the list
Reconcile list
Call pharmacy or call family
Consolidate meds
Incorporate into med list
Enumerate all meds
Evaluate ongoing need of each med.