The Personal Medication Record - Part I

[As I had indicated before technical problems intervened, the next AlignMap posts will deal with pragmatic tips for decreasing medication noncompliance by error with methods now available. Today's post is the first in that series.]

1. To achieve optimal healthcare in general and decrease unintentional medication noncompliance in particular, every individual needs a Personal Medication Record¹ - a list that (1) includes at least the names of all the medications currently taken by the individual, the dosage of each medication, and the problem each medication is treating and (2) is readily accessible to that individual and to those treating that individual.

2. Every individual needs a Personal Medication Record, regardless of the individual’s age, health status, and amount or type of medications taken, including those taking no medications.

A Medication List Is Essential For Optimal Healthcare and Patient Compliance

This is hardly a controversial recommendation. The most restrictive Google search for the term, “personal medication record,” shows over 13,000 hits, and my cursory scan of at least the first 100 indicates they are sites offering to provide such records or to instruct clients in their use.

Everyone Means Everyone

Yet, the large majority of these recommendations are directed at the elderly. And, while one might argue that older patients have the greatest need for such lists because they tend to take more different medications and to have more problems with memory than younger individuals, that hardly negates the value of a personal medication record for everyone else.

Spinning scenarios in which the brightest young adult on a single medication might nonetheless need a personal medication record is easy and amusing.

Less dramatically, it’s far too easy for anyone, even with an intact memory, to forget to include a medication, especially if it is an over-the-counter preparation or is taken only as needed, or to fail to notify one doctor’s office of a dosage change made by another doctor. Most of us have had the experience of shopping at the grocery store, only to return home without the item that was the primary reason for the trip. And, consequently, most of us acknowledge the wisdom of a grocery list. Well, “The Personal Medication Record” is, in its fundamentals, the gussied up version of that grocery list that we usually scrawl on the back of an envelope.

Even more mundanely, it saves time and reduces anxiety if one can respond to the triage nurse’s standard and important query, “Do you take any medications?” by handing over a written list rather than attempting to re-create that list from memory at a time when ones psychological and physical condition may be impaired.

And, “everyone” includes those who take no medication. The most empathic and clinically astute physician cannot ascertain from the absence of a medications list if the patient is taking no medication, one medication, two medications, 24 medications, … . A medication listing that reads “22 April 2007 - Currently taking no over the counter or prescribed medications” is potentially as useful as a list containing a dozen prescribed drugs.

Now that it’s clear Who should have a personal medication record (everyone, regardless of age and regardless of if he or she takes medication), the next post will focus on how to go about choosing Which of the many personal medication records available is best for a specific patient.

Footnotes

1. There is currently no formal definition of “Personal Medication Record” that is widely accepted, let alone a standardized Personal Medication Record format. A later post will discuss at length the essential and optional elements of a Personal Medication Record, but for now the Personal Medication Record can described, as it is above, as “a list that (1) includes at least the names of all the medications currently taken by the individual, the dosage of each medication, and the problem each medication is treating and (2) is readily accessible to that individual and to those treating that individual.” [back]

• Many Losers In Patient Medication Quiz
• A Brief Blogging Interlude
• Medication Noncompliance - The Blog
• Welcome To The AlignMap Clinic
• Nonadherence To Posting Schedule