By Holly Clark Crawley, PharmD, BCPS, BCCCP
Managing patients with multiple chronic conditions requires careful coordination across providers, medications, and healthcare settings. In busy outpatient clinics, important details related to medications and care coordination can easily be overlooked, yet these gaps often contribute to preventable complications.
Torch Wellness pharmacists work directly with outpatient clinics to support providers through medication management and care coordination. Pharmacists are uniquely positioned to identify medication-related risks, uncover gaps in care, and help ensure that treatment plans remain safe and organized.
Through our work with patients in outpatient settings, we have identified several common issues that can impact preventive care and chronic disease management. The checklist below highlights several areas that provider offices may find helpful when managing patients with complex medication regimens. The examples included are based on real situations encountered during care coordination this year.
- Maintain a Complete Prescription Medication List
Every patient should have a complete list of prescription medications that includes all therapies prescribed by any provider involved in their care. Maintaining an accurate medication list helps reduce the risk of drug-drug interactions, duplicate therapies, and unintentional medication errors.
Example: During a medication review, a patient was found to be taking blood pressure medications prescribed by both their primary care physician and cardiologist, resulting in duplicate therapy.
- Document All Over-the-Counter Medications
Over-the-counter medications are frequently overlooked during routine visits, yet they can impact patient safety. OTC products may interact with prescription medications or pose risks for older adults. Patients should be asked specifically about what they regularly take. Example: An elderly patient was discovered to be taking 325 mg aspirin several times per day for pain, greatly exceeding recommended dosing.
- Maintain a Current List of Providers and Specialists
Patients with multiple chronic conditions often see several specialists, which can lead to fragmented care if communication is limited. Maintaining a clear list of specialists helps providers coordinate treatment plans, avoid duplication of therapy, and identify medications that may worsen another condition. Example: A patient being treated by a urologist for overactive bladder was also taking a diuretic for blood pressure, contributing to worsening urinary symptoms.
- Perform Medication Adherence Check-Ins
Medication adherence is often assumed, but not always verified. Even when patients refill prescriptions regularly, misunderstandings about dosing or scheduling can occur. Asking patients to explain how they take their medications can reveal barriers such as confusion about dosing, cost concerns, or health literacy challenges. Example: One patient receiving pre-packaged medications did not realize the packets were labeled by day and time, leading to incorrect dosing.
Key Takeaways for Provider Offices
- Maintain a complete medication list, including prescriptions from all providers.
- Always ask patients about over-the-counter medications and supplements.
- Keep an updated list of specialists involved in the patient’s care.
- Regularly perform medication adherence check-ins to identify barriers.
- Small medication-related gaps can lead to significant downstream complications if left unaddressed.
Holly Clark Crawley, PharmD, BCPS, BCCCP is the Director of Clinical Services with Torch Wellness.
