What a medication review is
Most adults with several health conditions have more than one medication list. The cardiologist has one. The hospital wrote another at discharge. The pharmacy has a third, and the pill organizer on the kitchen counter is a fourth. They rarely match.
A medication review at home puts those lists side by side with the actual bottles. A clinician or pharmacist looks at what each medication is for, whether anything is duplicated or missing, and whether the way you take it matches what was prescribed. Clinicians call the comparing step medication reconciliation.
Why reviewing at home works well
At an office visit, people recite a list from memory, and memory leaves things out. At home, everything is within reach: old bottles, samples, eye drops, creams, vitamins and drugstore remedies.
The clinician can also see whether a pill organizer is filled correctly, whether labels can be read, and whether expired medications are mixed in with current ones. Some reviews can be done by a telehealth visit, with someone holding each bottle up to the camera.
Sorting out the lists after a hospital stay
Discharge is a high-risk time for medication mix-ups. Hospitals often stop some medications, start others and change doses. The discharge list reflects those decisions, but the cabinet at home does not.
Common problems include:
- Taking both an old medication and its replacement
- Taking the same medicine twice, once under a brand name and once under a generic name
- Restarting something the hospital stopped on purpose
- Leaving a new prescription unfilled because of cost or confusion
This comparison is a central part of follow-up care after discharge. Until a clinician has gone over the lists, follow the discharge instructions and call the hospital, your pharmacist or your physician with questions. Do not stop or restart anything on your own.
Medications and wound healing
Some medications affect how wounds heal or how they are treated. Steroids and other drugs that calm the immune system may slow repair. Blood thinners matter when a wound bleeds or needs a procedure. Water pills change leg swelling.
These medications are usually prescribed for good reason, and the benefit often outweighs the effect on healing. That judgment belongs to the prescriber. What helps is making sure the wound care clinician knows everything you take, including any cream or ointment used on or near the wound. Our guide to medications that can affect healing explains the main groups.
Questions to ask the prescriber
Bring these to the review, or to the clinician who prescribed the medication:
- What is this medication for, and is it still needed?
- How and when should I take it, and what should I do if I miss a dose?
- Which side effects should I report, and which mean I should call right away?
- Could any of my medications make me dizzy, sleepy or more likely to fall?
- Could any of them affect my wound or my blood sugar?
- Who will refill this, and when is the next check or blood test due?
Raise dizziness and drowsiness plainly, since some medications add to fall risk.
What Gateway arranges
Your treating clinician reviews medications and decides whether a prescription should change. Gateway can include a medication review in primary care follow-up and coordinate questions with your existing prescribers.
We also handle the work around it: gathering discharge lists and records beforehand, sending the clinician’s questions to other prescribers, and sharing the updated list with the wound care team, home health or facility staff, as part of our care coordination.
Side effects and when to call
Report new symptoms after any medication change: rash, dizziness, unusual sleepiness, confusion, stomach upset, unusual bruising or bleeding, or swelling. If you are unsure whether to take the next dose, call the prescriber or pharmacist first.
Call 911 for trouble breathing, swelling of the face, lips or tongue, fainting, a seizure, bleeding that will not stop, or if someone may have taken too much of a medication. Gateway is not an emergency service.
How to start
Call 314-325-0126, or send the request care form with a name and phone number only. Patients and family members across Greater St. Louis and the Metro East can call directly.
Before the visit, set out every medication in one place. The guide to keeping an up-to-date medication list shows what to write down.
Common questions
What should I gather before a medication review?
Everything you take or use: prescription bottles, over-the-counter pain relievers, sleep aids, vitamins, herbal products, eye drops, inhalers, patches, injections and skin creams. Add the hospital discharge list if you have one and the name of your pharmacy. Include medications you stopped recently and note why.
Who can do a medication review?
A physician, nurse practitioner, physician assistant or pharmacist can review medications. Nurses often gather the list and flag concerns for the clinician. Decisions to change, stop or add a medication belong to a prescriber, ideally the one who started it or the one responsible for your overall care.
Can I stop a medication if I think it is slowing my wound?
Please do not stop it on your own. Some medications are dangerous to stop suddenly, and many protect you from serious problems such as clots, strokes or flares of illness. Tell the wound care clinician and the prescriber about your concern. They can weigh the risks and decide whether any change makes sense.
My parent takes medications from several doctors. Who is in charge of the whole list?
Usually the primary care clinician, who can see every prescription together. If your parent has no primary care clinician, Gateway can help connect them with a practice. In the meantime, filling all prescriptions at one pharmacy helps the pharmacist spot duplicates and interactions.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.