American Society of Health-System Pharmacists

Do not continue medications based solely on the medication or dispensing history unless the history has been verified with the patient by a medication use expert (e.g., a pharmacist) and the need for continued therapy has been established.

The patient or caregiver should be the primary source of truth, with medical records and pharmacy refill information as secondary sources, when taking the medication history. The patient or caregiver should be interviewed by someone with medication-use expertise, ideally a pharmacist, and medications should be continued only if there is an associated active medical indication. If a pharmacist is not available, then at a minimum, the healthcare worker taking the history should have access to robust drug information resources. The history should include the drug name, dose, units, frequency, and the last dose taken, and indication. A medication-use expert should lead medication reconciliation processes during high-risk transitions of care to assure correct and optimal therapy for the patient.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.