What is medicine reconciliation?

Medicine reconciliation is the process of building one complete, checked list of every medicine a person takes, across all their doctors. It means collecting what is actually in the house, comparing it with what each doctor prescribed, and confirming any differences with the prescriber. Hospitals do it formally when someone is admitted or discharged. Families can do a simple version at home.

For an older parent, the list is rarely in one place. A cardiologist, a diabetes doctor and a family physician each write their own prescription. Some medicines come from a pharmacy, some from a hospital, some from a neighbour's suggestion. Nobody holds the whole picture, and that gap is where mix-ups start.

Why a single list matters

• Brand names hide the ingredient. The same active ingredient is sold under many brand names. A record that contains both Ecosprin and Disprin contains two brand names, and both contain aspirin as an active ingredient. A family can't see that from the names alone, and it's worth asking the prescribing doctor whether both are intended. Two medicines with the same ingredient are not interchangeable: which one to take is the doctor's call.
• Prescriptions go stale. A medicine a doctor stopped can still be in the cupboard, and still be on an old slip.
• Each doctor usually sees only their own slip. Without a combined list, a new specialist starts from your memory.
• Discharge is a common moment for mix-ups. A hospital sends someone home with a new set of medicines and often a changed old set. The discharge summary and the old strips rarely agree on their own.

When to do it

• after any hospital stay, on the day the parent comes home
• when a new doctor or specialist is added
• whenever a prescription changes
• once a year, as a routine, even if nothing has changed

How to do it at home: five steps

1. Gather everything. Every strip, bottle, inhaler, drop and cream in the house, plus the latest prescription from each doctor. Include medicines bought over the counter and any supplements or herbal products.
2. Write one line per item. Name as printed, strength, the composition on the strip, how often and when, who prescribed it, and the date. Our guide to reading a prescription helps with the shorthand.
3. Compare against the prescriptions. Mark anything in the house that no prescription mentions, and anything prescribed that isn't in the house.
4. List your questions. Items that look like the same ingredient, items with no prescription, items that have no duration or no timing. Write each as a question for the doctor, not as a conclusion.
5. Confirm with the prescriber or pharmacist. Take the list and the strips to the doctor or pharmacist, ask each question, and write down the answers. Then update the list the same day.

Don't stop, start or change a medicine yourself at any step. The reconciliation is how you find the questions. The doctor is how you get the answers.

What a good list looks like

Keep it in one place the whole family can see, and bring it to every visit. Our guide to managing an elderly parent's health at home covers the rest of the routine.

Where PURE Care fits in

Doing this by hand is possible, and keeping it current is the hard part. PURE Care keeps one clear, current medicine list for your parent, shared with the family. When two items in the record look alike, we point it out, and you can confirm with your parent's doctor. Join the waitlist.