Medication list: keeping an accurate history of your treatments

The World Health Organization has made medication safety one of its global patient safety challenges. Medication Without Harm aims to halve severe, avoidable medication-related harm, and names three priority areas: high-risk situations, polypharmacy and transitions of care.

Those are exactly the moments when an incomplete list matters most: when several prescribers are involved, or when a treatment changed in hospital has to be continued at home. Over-the-counter medicines, herbal products and supplements count too. Before adding a product, the WHO encourages patients to ask whether they have told their health professional what they already take, and whether the new product can interact with their other medicines.

One line per product, with:

• the exact name on the box and, if possible, the active ingredient;
• the strength and form: tablet, capsule, syrup, injection…;
• how much you take, and when;
• why you take it, as it was explained to you;
• the start date and, where relevant, the stop date;
• the prescriber or the context: appointment, hospital stay, self-medication;
• reactions you noticed, doses you often miss or any difficulty.

Add what appears on no prescription: occasional medicines, vitamins, herbal products, supplements. A photo of the box or the prescription often settles an ambiguity, as long as it is legible and current.

Finally, keep what was prescribed separate from what you actually take. A gap is not something to hide: it is exactly the information the professional needs.

One reference version, dated

Keep a single reference list and write down the date it was last updated, including on any printed copy. After a change, archive the old version rather than overwriting it: the timeline shows what was tried, at what dose, and why it was stopped. The same principle applies to all your health documents, and our guide to the personal health record explains how to organize them. If a relative helps you manage your treatments, agree on their role and what they can see: access to your health information should never be assumed.

These words are not interchangeable, and a mix-up recorded once tends to travel from one file to the next. France’s medicines agency, the ANSM, describes a side effect as an unusual or unwanted event that you suspect is linked to taking a medicine. An allergy involves a specific mechanism, which a professional must confirm before it is recorded as such. And a treatment that does not seem to work raises a different question again.

In every case, write down facts rather than a conclusion: the symptom, how long after the dose it started, how long it lasted, how strong it was, what else you took at the same time and what you did. “Dizzy an hour after the morning dose, for three days” will help more than “I’m allergic.”

What to do if you have a reaction

If a symptom seems serious, call your local emergency number (15 or 112 in France, 112 anywhere in the European Union). Otherwise, contact your doctor or pharmacist promptly: they will help you assess the reaction and decide what comes next. Do not stop a prescribed treatment on your own unless you were told in advance that you could: some medicines should not be stopped suddenly, and that is one of the questions the WHO’s 5 Moments for Medication Safety tool encourages you to ask.

Side effects can also be reported. Most countries run a reporting system open to patients: the Yellow Card scheme in the United Kingdom, MedWatch in the United States, and in France an official reporting portal whose reports go to the regional pharmacovigilance centres. Your doctor or pharmacist can also report it for you.

Review your list:

• after a new prescription or a change of dose;
• when you leave hospital or the emergency department;
• when a new specialist gets involved;
• after a side effect;
• when the packaging of a medicine or your pharmacy changes;
• before anesthesia, surgery or a long trip.

In hospital, these transitions have a process of their own: medication reconciliation. The French National Authority for Health (HAS) describes it as a way of preventing and intercepting medication errors to keep a patient’s treatment continuous. It is carried out by professionals, starting with gathering information on the medicines the patient actually takes. Your list makes that first step easier, without replacing it.

Before the appointment, mark the products you have a question about, and note missed doses without playing them down: a treatment that is hard to follow is worth discussing. Bring your latest prescription and, if your treatment comes with regular blood tests, the most recent results; our guide on how to read blood test results helps you go through them without drawing conclusions alone. If several professionals prescribe for you, ask who coordinates the whole picture.

Three questions are often enough. The WHO tool, designed for patients and their families, suggests some for each stage: starting, taking, adding, reviewing and stopping a medicine. For example:

• What is this medicine for?
• How long should I take it?
• What should I do if I miss a dose, or if I have a side effect?

For the rest of the visit, documents and questions included, see our guide on how to prepare for a doctor’s appointment.

An app can remind you to take a dose, keep track of a change of dose or flag a possible interaction. To be reliable, it has to separate the original prescription, what you entered yourself and the alerts it generated automatically.

An alert is not a treatment decision. It can be wrong if a product is missing from the list or a dose was entered incorrectly. Who validated the rule, for which people, and what to do next: that information should be visible.

With MyTwin for patients, your treatments sit alongside your medical history, your vital signs and your reports, in a dated record you can share with your doctor or pharmacist. Partner apps can use it to simulate, for information purposes, how a treatment might suit your profile; the decision to start, change or stop a medicine stays with the prescriber. Kunan’s story — at 52, his blood pressure treatment left him dizzy and exhausted — shows the need clearly: reactions he reported, but no overall view of his history to put them in context.