Name of the Procedure:

Review of all medications by a prescribing practitioner or clinical pharmacist (Medication Review)

Summary

In layman's terms, this procedure involves a thorough review of all medications a patient is taking, including prescriptions, over-the-counter drugs, herbal therapies, and supplements, to ensure they are safe, effective, and appropriate. The review is documented in the patient's medical record.

Purpose

This procedure addresses issues related to medication management and safety. The goals are to identify any potential drug interactions, ensure correct dosages, remove unnecessary medications, and optimize therapeutic effectiveness.

Indications

• Multiple medications prescribed (polypharmacy)
• Chronic diseases requiring regular medication management
• Symptoms of potential drug interactions or side effects
• Recent discharges from the hospital with new or changed medications
• Patients on complex medication regimens, including multiple herbal or dietary supplements

Preparation

• Patients should bring a list of all their current medications, including prescriptions, over-the-counter drugs, herbal supplements, and vitamins.
• No fasting or medication adjustments are generally required unless specified.
• Blood tests or other diagnostic assessments may be needed to check levels of certain medications.

Procedure Description

1. The patient provides a complete list of all medications.
2. The healthcare professional reviews each medication, checking for potential interactions, correct dosages, and therapeutic appropriateness.
3. Any discrepancies or concerns are discussed with the patient.
4. Recommendations for changes or adjustments are made and documented in the patient's medical record.

Tools and Equipment:

• Medical records
• Patient's medication list
• Clinical decision support systems (if available)

Anesthesia or Sedation:

• Not applicable

Duration

The procedure typically takes about 30 to 60 minutes, depending on the complexity of the medication regimen.

Setting

This procedure can be performed in various settings, including hospitals, outpatient clinics, or during home visits by healthcare providers.

Personnel

• Prescribing practitioners (e.g., physicians, nurse practitioners)
• Clinical pharmacists

Risks and Complications

• There are minimal risks associated with the review itself.
• Potential risks include incorrect discontinuation or adjustment of medications if not properly managed, but these are rare.

Benefits

• Improved medication safety and effectiveness
• Reduced risk of adverse drug interactions and side effects
• Potential simplification of medication regimen
• Better disease management and overall health outcomes

Recovery

• No physical recovery required
• Follow up with the healthcare provider may be necessary to monitor the effects of any changes made to the medication regimen.

Alternatives

• Self-review of medications or consultation with a pharmacist at a local pharmacy, although these may not be as thorough or detailed.
• Use of medication management apps, which may not replace professional evaluation.

Patient Experience

• Patients will engage in a detailed discussion about their medications.
• Any questions or concerns from patients will be addressed.
• The overall experience is generally informative, aiming to improve their health management.
• Pain management or comfort measures are not typically needed, as the procedure is non-invasive.