Hospital to Home: Managing Medication Transitions
The transition from hospital to home is one of the most dangerous times for medication errors. Nearly 20% of patients experience adverse events after discharge, many involving medications. Proper planning prevents problems.
Why This Transition Is Risky
After hospitalization:
- Medications are often changed
- New medications are added
- Old medications are stopped
- Doses are adjusted
- Instructions may be unclear
- Patients are tired and overwhelmed
- Follow-up may not happen quickly
Before Leaving the Hospital
Get Complete Information
Request and review:
- Discharge medication list with all current medications
- Medication reconciliation comparing new list to old
- Clear instructions for each medication
- Written information about new medications
- Reason for each change (what was stopped and why)
Ask Key Questions
For each medication:
- What is this medication for?
- How do I take it?
- What side effects should I watch for?
- Does it interact with anything I take?
- When do I follow up about this medication?
Before You Leave the Room
- Confirm understanding of all medications
- Get prescriptions or know they've been sent
- Pharmacy information is on file
- Follow-up appointments are scheduled
- Contact numbers for questions
The First Week at Home
Day 1: Organize
- Obtain all new prescriptions
- Compare hospital list to what you have at home
- Remove discontinued medications
- Set up new pill organizer
- Create a medication schedule
Day 2-3: Verify
- Call pharmacist with questions
- Confirm no interactions with home medications
- Make sure you can open and take all medications
- Set up reminder systems
Day 4-7: Stabilize
- Follow the schedule consistently
- Note any side effects or concerns
- Prepare questions for follow-up appointment
- Contact provider if problems arise
Red Flags After Discharge
Contact your doctor immediately if you experience:
- Confusion or drowsiness
- Falls or dizziness
- Bleeding or bruising
- Severe side effects
- Symptoms returning
- Allergic reactions
- Unable to take medications as prescribed
Medication Reconciliation Checklist
Compare your lists carefully:
Medications That Should Match
- Name and dose are identical
- Timing/frequency is the same
- Form (tablet, capsule, liquid) matches
Changes to Understand
- New medications: Why added?
- Stopped medications: Why discontinued?
- Dose changes: Why adjusted?
- Timing changes: Why different?
Potential Problems
- Duplicate medications (same drug, different names)
- Missing medications you expected to continue
- Interactions between new and old medications
- Medications you can't afford
For Family Caregivers
Your role during transition is critical:
At the Hospital
- Attend discharge teaching
- Take notes
- Ask questions the patient might not think of
- Request printed instructions
At Home
- Help organize medications
- Ensure prescriptions are filled
- Monitor for problems
- Attend follow-up appointments
Ongoing
- Use tools like CareForMeds to track adherence
- Maintain updated medication list
- Communicate with healthcare team
- Watch for warning signs
Key Contact Numbers
Keep these handy after discharge:
- Primary care physician: _____________
- Hospital follow-up: _____________
- Pharmacy: _____________
- Specialist: _____________
- Nurse helpline: _____________
- Poison Control: 1-800-222-1222
The 30-Day Window
The first 30 days after discharge are highest risk:
- Keep all follow-up appointments
- Don't stop medications without asking
- Report problems immediately
- Ask for help if overwhelmed
A safe transition requires planning, attention, and support. Don't hesitate to ask questions—your health depends on it.