Medication safety
A patient returned to the community after a prolonged hospital stay for a high-risk cardiac condition. During hospitalization, several medications were changed—some stopped, new ones added, doses adjusted. The hospital provided only a one-month supply, expecting the patient to follow up with their family physician for ongoing prescriptions.
When the patient came to refill their medications, the family physician’s prescriptions were based on outdated records, not reflecting the recent hospital changes. I noticed this discrepancy during the refill request and immediately compared the physician’s prescriptions with the current hospital discharge summary. There were significant differences that could affect the patient’s safety.
I faxed the physician for clarification but didn’t receive a timely response. Given the risk, I reviewed the provincial discharge records and extended the patient’s therapy according to the latest medication plan. Later, I took the additional step of personally delivering the discharge documents to the physician’s office. The doctor appreciated the intervention, acknowledging it helped avoid potential adverse effects and ensured continuity of care for the patient.
Because of a pharmacist, something important happened.
