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Reporting a Medication Error

Hospital to home: Know your medicines before you leave

Heading home after a hospital stay can be overwhelming. An important part of going home safely is understanding your medicines before you leave the hospital. The medicines you were taking before being hospitalized may have been changed or stopped, or new medicines may have been added during your hospital stay.

ISMP received a report from a consumer whose blood pressure medicines were changed while she was in the hospital. However, she did not know about all the changes, and neither did her community pharmacist. After a few days of taking her medicines, including the ones that were supposed to have been stopped, she felt very weak. Her blood pressure dropped so low that she had to be taken back to the hospital in an ambulance.

Here’s what you can do: To help you safely return home from the hospital:

  • Ask your hospital healthcare provider team to give you an up-to-date medicine list (including prescription and nonprescription medicines) before you leave the hospital. That list should include only the medicines you need to take at home and should list the name of each medicine, the dose, the instructions for use, and the purpose of the medicine.
  • Be sure you understand what previously taken medicines should be stopped or if the doses have changed. If you have any remaining supplies of prescription medicines that should be stopped, discard them immediately when you get home.
  • When filling your new prescriptions, tell your community pharmacist about your recent hospital stay.
  • If doses of existing medicines have changed, ask your pharmacist if you can use the medicines you have at home. If you can, write down new instructions that will meet the newer dose prescribed. If not, discard the medicine so you do not confuse it with the newer prescribed dose.
  • Share your medicine list (including prescription and nonprescription medicines) with your family doctor, community pharmacist, and any other members of your care team.
  • Ask questions about anything that doesn’t make sense or that you are confused about! It’s your health, and you have a say in it—make sure you understand and are okay with any changes that have occurred and the plan going forward post-discharge.

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