Medication Management Review

Generally, the student team should conduct a medication review. If a pharmacy student is part of the team s/he can lead the review, though all students should participate, with the goal of learning from, with and about each other. The activity can be a medication therapy management session, if an appropriately trained preceptor is available. The team will follow the criteria found in KM14–KM17. The student team:

  • Reviews, reconciles and documents all medications the patient is taking, including resolving all medication conflicts (KM14)
  • Provides patients/families/caregivers with information about a new medication, including potential side effects, drug interactions, instructions for taking the medication and the consequences of not taking it (KM16)
  • Assesses how well patients understand the information about medications they are taking, and considers a patient’s health literacy (KM16 as well as KM8)
  • Asks patients about a problem or difficulty taking a medication; whether they are experiencing side effects; and whether the medication is being taken as prescribed. If a patient is not taking a medication as prescribed, the team determines why (KM17)
  • Reviews and documents in the medical record any nonprescription medications, such as over-the-counter (OTC) medications, herbal therapies and supplements that the patient is taking, with the overall goals of preventing interference with prescribed medication and evaluating potential side effects. (KM15)