What happens when different doctors prescribe different medications?


Q: My mother sees several different doctors for her medical care. How does one doctor know what medication the other doctor has prescribed?

A: One of the biggest problems we have in our health system today is accurate and timely information; this is especially true regarding the medications we use.

At each healthcare appointment, we are asked to provide or update information about our medical conditions and the medications that we use. Most patients/caregivers document this from memory. This is where the problems begin. Patients/caregivers usually forget the prescribed medications that are used only as needed. Other medications that are also frequently forgotten are the non-prescription or supplement mediations.

Non-reported medications as well as the increasing number of medications contribute to the medication related problems. Medication related problems in seniors are a leading reason for their emergency rooms visits and their admissions to hospitals, nursing homes, or long term care facilities.

I recommend that each patient/caregiver maintain a comprehensive list of both their medical conditions and medications to assure that the information can be consistently provided to all healthcare providers (doctors, pharmacists, therapists, etc.) to keep them accurately and timely informed. If you visit my website, you with find an excellent form, Health ICE, (Health In Case of Emergency) that can assist in organizing the information that should be reported to healthcare providers.

Lynn Harrelson is a pharmacist who specializes in medication and prescription management for seniors. She provides health care services and information that help individuals remain independent in their homes, retirement and assisted living facilities.

Senior Pharmacy Solutions

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10 things you need to know about your aging parents' health
adapted from the Mayo CLinic for Canadian readers.

1. Health Cards. This will have more information, and may be in a wallet, or not!

2. Names of their doctors. This is one of the first questions they will ask. Primary physicians, as well as specialists: heart, oncologists, will have the most up-to-date records. Also, find out the phone number and office locations.

3. List of allergies, infections, eating disorders, addictions. This is especially important if one of your parents is allergic to medication — penicillin, for example, or food allergies. Some seniors have Sundowner's Syndrome, and

4. Advance directives; Power of attorney for personal care. * Know where they are, and your parent's wishes for DNR orders, or other issues. This is an important discussion for you to have with them. Start be telling what YOU would wish.

5. Major medical comorbidities. This includes such conditions as diabetes or heart disease. My mother had colitis, celiac disease, skin conditions, white coat syndrome - high blood pressure, and she was lactose intolerant). She needed a special diet when in hospital.

6. List of medications and/or supplements. Many seniors jump on bandwagons, and take over-the-counter vitamins, or herbal supplements, and these might interact with blood thinners, or other medications. You pharmacist can give you a list if you go with your parents and talk to them about it. If your parent is incapable of keeping them straight, talk to the pharmacist.

7. Prior surgeries and major medical procedures. List past medical procedures including implanted medical devices such as pacemakers. I wrote in my personal agenda whenever my mother had surgery, when she had radiation treatments or follow-up appointments. Once I scanned this, I realized she was developing a tumour a year between 2002 and 2006. Otherwise, it is worth it to write down all of their issues and concerns. If they have questions, e.g., my mom didn't know what Leukplakia was, her type of cancer. I collected this information for her.

8. Names and phone numbers of extended family and close friends. We were unaware of some of these people, and neglected to speak to some.

9. Activities of Daily Living. ADLs and IADLs (see below) are a good indication of personal health. If your parent has been getting Meals on Wheels, or has been incapable of getting groceries, of banking on their own, a geriatrician may be able to help you with assistance. They need to know, before discharge, how able your parents are. I knew of a woman, my age, with a full-time job, and both parents and in-laws with health issues, including serious surgeries - all at the same time. She was expected to be their Charge Nurse, and Personal Support Worker.

10. Hospital discharge of seniors (I did a full post on this!). Another great resource is the newly established 211Ontario.ca services locator website. Muskoka has just signed on and provides many resources.

Your parent should have a Geriatric Assessment, to determine their ability to manage alone. Stand firm, if you do not think they CAN manage alone. There should be pre-admission screening to assess functional impairment, medical complexity, psychological functioning, and social supports.
I keep a comprehensive list of meds Hubby takes. Give that list to each doctor we go to. GP, Urologist, Foot, Neurologist, Dermatologist. I use the GP as my target guy. Today, neurologist says Hubby doesn't need "this" medicine. But GP prescribed. AND, I do keep routine 3 month appts with each doctor. So, one md says yes and another md says no. Any thoughts? Please?
Cheyenne93, any time I go to a specialty doctor, that doctor will automatically email a report to my primary doctor. And if the primary doctor is on-line when that email is sent, he/she can automatically answer back. See if that is something your doctors can do.