How to keep an accurate medicine list (and keep it up to date)

Why an accurate list matters

Medication errors are one of the most common avoidable problems in health care, and many happen at transition points: a hospital admission, a new GP, a respite stay or a change of support worker. At each of those moments someone has to answer the question “what does this person take?” If the answer lives only in a parent’s memory, it is easy for a dose, a timing or an allergy to be missed.

A written list also protects you. When a specialist asks whether a medicine has been tried before, a dated history means you can answer with confidence rather than guessing.

What to record for every medicine

A good entry answers every question a nurse, pharmacist or new carer might ask. For each medicine we record:

• The brand name and the active ingredient (for example “Epilim — sodium valproate”), because pharmacies often substitute generic brands.
• The strength of the tablet, capsule or liquid (e.g. 200 mg per 5 mL).
• The dose actually given, and how it is given — swallowed, via a feeding tube, under the tongue, as a patch.
• The exact times of day, and whether it must be taken with food.
• Why it was prescribed, in plain words.
• Who prescribed it and the date it was started.
• Any special instructions, such as “crush and mix with yoghurt” or “do not give within two hours of iron supplements”.

Don’t forget the “hidden” medicines

Lists are most often incomplete because of the things people don’t think of as medicines. Include “as needed” (PRN) medicines such as pain relief or rescue medication, along with the circumstances in which they should be given and the maximum dose in 24 hours. Include vitamins, supplements, herbal products, thickening agents, creams, eye drops, inhalers and anything purchased over the counter. Some supplements interact with prescription medicines, so your doctor and pharmacist need to know about them.

Log every change with a date and a reason

The single habit that transformed our records was writing down every change the day it happened: “12 March — levetiracetam increased from 250 mg to 375 mg twice daily by Dr Nguyen because of breakthrough seizures.” Over time this becomes a medicine history that is invaluable when doctors review what has and hasn’t worked.

When a medicine is stopped, don’t delete it. Mark it as stopped, with the date and the reason (side effects, not effective, course finished). A clear record of previously trialled medicines prevents the same unsuccessful treatment being suggested again.

Check your list against the source

Every few months, and after any hospital visit, compare your list against the pharmacy dispensing labels and the latest letters from doctors. Many community pharmacists will do a free medicine review on request and can print a dispensing history. In Australia, people taking multiple medicines may also be eligible for a Home Medicines Review arranged through their GP, where a pharmacist visits and goes through everything with you.

Make it easy for others to use

A list that only you understand is not much better than no list at all. Use plain language, avoid abbreviations such as “bd” or “nocte” unless everyone knows them, and keep allergies and adverse reactions at the top where they cannot be missed. Make sure anyone who gives medicines — a partner, grandparent, respite house or school nurse — can see the current version, not a photocopy from last year.