I have wanted to write a very general and basic note about taking all your prescribed and non-prescribed medications when you visit your doctors (any specialty). I would like to explain this by writing about one of my own patients.
Patient XYZ is a 62 year old man who has diabetes, hypertension, hyperlipidemia, chronic kidney disease, coronary artery disease, orthostatic hypotension (and some dizziness). He does not follow up with a primary care physician (PCP) and likes to see only specialist for all his concerns. Having a PCP as a family doctor would be an excellent idea as they know the patient as a whole and could definitely help to place necessary referrals and reconcile medications and investigations.
So, this patient sees an endocrinologist who manages his diabetes and also does preventive bone loss strategies. She also addresses hypertension and hyperlipidemia in addition to the neurologist/cardiologist and nephrologist doing the very same thing. Similarly, his entire super specialty consultant modifies his medications/doses which at times can be very very confusing for the patient. It would be a very healthy practice to review other medications/prescriptions and even better practice would be to talk to the other consultant about so and so medication/dose change. But this is seldom done in clinical practice. Patient XYZ ends up on two statins (for cholesterol), two different calcium and vitamin D preparations, two different ARB inhibitors ( for blood pressure) and ends up taking close to 20 medications in addition to over the counter supplements (Revittal, omega 3, flax seed, vitamin E, vitamin C etc).
We are just not talking about the cost of medications but also the poor compliance with medications, side effects and drug interactions. So, kindly take all your medications with you when you meet your doctor and also know the indication (why am I taking this medication?) for the medication prescribed.
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