As strange as it may sound, coming home from hospital is one of the more common times when medicine mishaps occur. However, being aware of the potential problems and being prepared beforehand can help prevent such mishaps.

Medicines list

You are more likely to have medicine-related problems during and after a hospital stay if the hospital does not know about all the medicines you are already taking. Typical problems that can occur while in hospital include not being given one of your medicines or being given a different dose of one of your medicines. If undetected, these problems can continue when you return home, because the medicines prescribed when you leave hospital will be based on what you were given in hospital.

Before you leave hospital, ask for a new medicines list, a
copy of your discharge summary, and details of any
changes to your medicines

You can minimise the likelihood of such problems by keeping (and preferably carrying with you) a complete list of all your medicines, including any herbal, natural, non-prescription and prescription medicines, and giving it to the hospital doctor. The list should include the name, strength and timing of each medicine and preferably the reason for taking it. If possible, also take all your medicines with you when you go into hospital.

To be useful, your medicines list must be accurate at all times. Keep it up to date by changing your existing list or asking your GP to print off a new list each time your medicines are changed.

Information about the changes

If you are not fully aware of the changes made to your medicines while in hospital, you are more likely to have medicine mishaps when you return home. If you have been given a generic version of your usual brand medicine, you may unwittingly take two brands of the same medicine and hence take a double dose. Alternatively, you may not take a newly prescribed medicine and so leave a problem untreated.

Getting information about the changes to your medicines before you leave hospital will help avoid such mishaps. However, doing so is easier said than done, and you will probably be too ill to absorb much information. Enlisting the support of a family member or friend before you go into hospital to obtain the information for you can minimise such problems.

If possible, you or your family member should start the process of obtaining information a day or two before your anticipated discharge. Discharge from hospital is usually a rushed procedure, so it is often difficult to find a doctor or pharmacist who can explain your medicines once the discharge process has begun. If a discussion is requested in advance, it is more likely to happen.

Before you leave hospital, ask for a new medicines list, a copy of your discharge summary and answers to the following questions.

• Has a new medicine been added?
  • What is its name, how and when should I take it, and what are its common side effects?
  • For how long should I take it, and, if necessary, who should I see to get another prescription?
  • Should I take the new medicine instead of or as well as a previous medicine?
  • If the new medicine replaces an old one, which one does it replace?
• Has a medicine been stopped?
  • Which one?
• Has the dose or timing of a medicine been changed?
  • Which one and how has it been changed?
• Who should I ring if I have questions about my medicines when I return home?

Informing your GP

Ideally, your GP should receive a letter about your hospital stay and any changes to your medicines immediately after you leave hospital. However, in practice, this may not happen.

Unfortunately, all too often, this lack of communication leaves you or your family member with the job of conveying to your GP the details of any medicine changes. It may also mean that your GP cannot write out a prescription for your medicines until they find out if any changes were made to your medicines while in hospital. Life will be easier for you and your GP if you have obtained a new medicines list and your discharge summary from the hospital before being discharged.

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Ongoing supply

The process of obtaining ongoing supplies of medicines after leaving hospital varies from state to state and hospital to hospital.

You may be given a 2–3 day supply of your medicines when discharged. If so, you will have to visit your GP and pharmacist within a couple of days for further supplies. In some hospitals, you may be given a prescription instead of a small supply.

If you or your family think it may be difficult to obtain ongoing supplies of your medicines soon after leaving hospital, tell the hospital staff. They may be able to give you a longer supply on discharge. Remember, you will probably be extremely tired for the first few days out of hospital and you may need a lot of help doing things. You and your family will probably not feel like running around visiting doctors and pharmacists. So, if in doubt, ask if you can have a longer supply!

If you use a Webster-pak for managing your medicines, it is important that you or your family member makes sure that your usual pharmacist is promptly given the details of any changes to your medicines. Tell the hospital staff that you use a Webster-pak and give them the name of your usual pharmacist. Also, show your usual pharmacist your new medicines list and discharge summary.