The goal seems simple and straightforward enough – the medication list should reflect accurately what the patient is currently taking. But getting to that goal when there are frequently significant discrepancies between what a provider has recommended and what a patient is taking creates significant challenges.
Patients frequently do not take medications they’ve been prescribed, for a myriad of reasons. They frequently don’t take them as they’ve been directed to do so. In many health systems, our support staff start this complex process of validating medication history and make notations to alert the provider to discrepancies so the provider can make decisions about discontinuing, changing sigs, or counseling the patient why it is critically important that they continue this therapy.
Too often providers blow past these comments, and meds that are outdated and long discontinued even legitmately remain on the medication list. But if we enable staff to discontinue medications that the patients report that they are not taking, we risk unrecognized discontinuation of therapies – suddenly the patient has a stroke and it turns out they were off their anti platelet therapy but the provider never knew.
Interested in how others have tried to balance this ongoing challenge of updating and maintaining the medication list.