What is medication reconciliation?

Medication reconciliation happens when health care professionals and patients work together to improve medication safety.

1. We compare your complete and up-to-date list ofmedications you take at home
with
2. the medications we give or plan to give youduring your hospital stay, or in clinic
and
3. try to find and resolve any differences withthe health care team.

How does medication reconciliation keep you safe?

• We make sure you take the right medications at the hospital and when you go home.
• It reduces the risk of medication mistakes.
• It helps you and your family keep an up-to-date medication list you can take with you whenever you need it.

When is medication reconciliation done?

We do medication reconciliation:

• when we admit you to the hospital
• when we move you from one area of the hospital to another
• before you go home from the hospital
• when you visit some outpatient clinics

How can you help?

1. Make a list of the medications you take at home.
   • Use the chart in this booklet or make your own.
   • List of all of your:
     • Prescription medications (for example: antibiotics or blood pressure pills)
     • Non-prescription medications (for example: Tylenol®/acetaminophen)
     • Vitamins and minerals (for example: vitamin D or calcium)
     • Herbal medicines (for example: St. John’s Wort)
     • Supplements (for example: glucosamine or coenzyme Q10)
   • Make sure you include things like:
     • Eye/ear drops, inhalers or nasal sprays
     • Medicated patches or creams
     • Medications you inject (for example: insulin)
     • Medication samples from your doctor
   • Write down any allergies you have to medications and/or food.
   • Write down your pharmacy and your family doctor’s contact information.
     

     Remember to update your list regularly with any changes youor your doctor makes.

2. Bring your medications or list of medications when you go to the hospital or clinic.
   • Your health care team needs to have a complete and up-to-date list. This allows them to check for any drug interactions (whether one medication could affect another).
   • Prepare a list of questions to ask your health care team about your medications.
3. Review all your medications with your doctor, nurse or pharmacist.
   • When you are ready to go home from the hospital, ask your doctor, nurse or pharmacist to review your medications with you.
   • Look at all of your medications before you take them.
   • Always talk to your pharmacist if you have any questions or concerns about your medications.
4. Understand your prescribed medications during your doctor’s visit.
   • Ask your doctor to explain what they write on any prescription, including the name of the medication and how often you should take it.
   • Tell your doctor you want the reason you are taking a medication written on the prescription. Knowing the reason will allow you and your pharmacist to avoid confusing medications that have similar names.
5. Keep medications in the same containers (bottles or boxes) they came in.
   • Many pills look alike. It can be hard to tell the difference between them if they are stored together in one bottle.
   • Keeping them in their containers will let you:
     • double check the information about the medication before you take it
     • keep track of when you need a refill
     • have your pharmacy contact information close by

Safely store and dispose of your pain medicine

Pain medicine that is not stored or disposed of safely could be stolen or taken by mistake.

Safe storage

• Store pain medicine in a locked drawer or cabinet.
• Do not share your pain medicine. Pain medicine prescribed to you can be dangerous to others.
• Don’t chew, crush or break pills or capsules unless your pharmacist tells you to.

Safe disposal

It is dangerous to keep unused or expired pain medicine that you no longer need.

• Take unused or expired pain medicine to a pharmacy for safe disposal.
• Do not flush medicine down the toilet.
• Do not throw medicine in the garbage.