Medication Risk Assessment for Your Patient
Yes, I can systematically evaluate your patient's medication list for potential risks including drug-drug interactions, drug-disease interactions, polypharmacy burden, and potentially inappropriate medications—this structured review is essential for preventing adverse drug events, hospitalizations, and falls. 1
How to Submit Your Patient's Medications
To perform a comprehensive medication risk assessment, provide the following information:
- Complete medication list including all prescription medications with doses and frequencies 1
- Over-the-counter medications, supplements, and herbal remedies 2
- Patient's age (particularly important if ≥65 years) 1
- Active medical diagnoses (comorbid conditions) 1, 2
- Renal and hepatic function if available 3
- Known drug allergies or previous adverse reactions 1, 3
- Recent medication changes (within past 28 days) 4
What I Will Assess
1. Polypharmacy Burden
- Flag if taking ≥5 medications (50-60% chance of drug-drug interaction with 5 medications; 90% chance with ≥10 medications) 1
- Polypharmacy increases risk of hospitalization, early treatment discontinuation, adverse drug events, and functional decline 1
2. Drug-Drug Interactions
- QT prolongation risks from medication combinations 1, 2
- Anticoagulant interactions and bleeding risk 1
- Serotonin syndrome potential from combinations of antidepressants, opioids, or other serotonergic agents 1, 5
- Cytochrome P450 interactions (common with opioids, antidepressants, antibiotics, antipsychotics) 1
- Lithium interactions (e.g., with ACE inhibitors like lisinopril) that increase toxicity risk 5
3. Drug-Disease Interactions
- NSAIDs in heart failure, chronic kidney disease, or hypertension 1, 2
- Anticholinergics in cognitive impairment 1
- Sulfonylureas in chronic kidney disease (hypoglycemia risk) 1
4. High-Risk Medications in Older Adults (Beers Criteria/STOPP)
- Sedatives/hypnotics, benzodiazepines, anxiolytics (fall risk, cognitive impairment) 1, 2
- Opioids (fall risk, respiratory depression) 1, 2
- Anticholinergics including diphenhydramine (delirium, falls, urinary retention) 1
- Hypoglycemic agents particularly sulfonylureas (severe hypoglycemia risk) 1, 2
- First-generation antihistamines 1
5. Medication Duplication
- Identify duplicate therapies or medications with additive side effects resulting in toxicity 1
- Concomitant therapy that may be redundant 1
6. Potentially Inappropriate Dosing
- Renal dose adjustments needed for medications cleared by kidneys 1, 3
- Hepatic dose adjustments for medications metabolized by liver 1
- Age-related dosing considerations 1
7. Medication Underuse (START Criteria)
- Missing indicated medications such as statins in coronary artery disease, antiplatelet agents after stenting 1
- Undertreated conditions that may have been overlooked in complex regimens 1
8. Specific High-Risk Drug Classes
The following medication classes warrant particular scrutiny: 3
- Anticoagulants/thrombolytics (bleeding risk)
- Antimicrobials (interactions, resistance)
- Cardiovascular agents (hypotension, arrhythmias)
- Central nervous system agents (falls, altered mental status)
- Insulin/hypoglycemics (hypoglycemia)
- Diuretics (electrolyte abnormalities)
- Corticosteroids (multiple adverse effects)
- Opiates (respiratory depression, falls)
- Anti-epileptics (drug interactions)
Clinical Outcomes I'm Protecting Against
The primary adverse outcomes associated with medication risks include: 6, 7
- Frequent falls (66% increased risk with potentially inappropriate medications/drug interactions) 6
- Hospital admissions (29% increased risk) 6
- Emergency department visits 1, 4
- Adverse drug events causing morbidity and mortality 1, 7
- Functional decline and geriatric syndromes 1
- Medication nonadherence due to complexity 1
What Happens After the Assessment
Based on the medication review, I will provide: 1, 2
- Specific medications to consider deprescribing (those where harm outweighs benefit)
- Dose adjustments needed for safety
- Alternative medications with lower risk profiles
- Monitoring parameters required for high-risk medications
- Simplification strategies to reduce pill burden and improve adherence
- Recommendations for physician follow-up on specific concerns
Submit your patient's complete medication list and clinical information, and I will provide a detailed, actionable risk assessment with specific recommendations prioritizing your patient's safety and quality of life. 1, 2