When you’re in the hospital and you hear you’ve been OK’d for discharge home, the last thing you’d want to do is to start asking questions. The natural urge to is grab your suitcase and head for the closest exit.
But last week Melissa Walton-Shirley, M.D., a cardiologist in Glasgow, Ky., raised an issue that is applicable to anyone who is ready to leave the hospital.
Her article, “My Top Six Easily Preventable Causes of Patient Death and Morbidity,” published on medscape.com March 15, 2016 (password needed), was focused on preventing serious medical errors and overlooking key information about patients. But one key paragraph caught my attention. It’s about drugs.
No matter who you are and why you’ve been admitted to a hospital, it’s critical that, before going home, you talk about drugs with your doctor. You should carefully review both the drugs you were taking, if any, when you landed in the hospital and any changes that were made in those drugs and dosages during your hospital stay.
It doesn’t matter if you had a baby, were in for knee replacement surgery or had a near-fatal heart attack, or anything in between.
That’s because sometimes the medications you were taking turned out to be part of your problem. Or, your surgery or the diagnostic exams you had highlighted a brand new problem you hadn’t known about. Or perhaps you’re coming home with a completely new diagnosis.
Other times, the drugs you were taking may have had a role in causing your problems. For example, you may have been taking too high a dose of medication designed to lower high blood pressure, and thus you fainted due to low blood pressure. Or perhaps your thyroid medication was too high, which caused palpitations , and you ended up in the emergency room. Maybe your blood thinner caused gastrointestinal bleeding.
Typically, doctors almost automatically click “continue home meds” when they discharge a patient from the hospital.
Instead, they should click “reconcile medications at discharge.” That means the physician, often in consultation with the patient and family, compares what the patient was taking at home and decides, drug by drug, what should change, given what was learned during the hospitalization.
Ask for that.