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What happens at an annual medication review?

What happens at an annual medication review? (Getty Images)

Your doctor may talk to you about all your prescriptions during your annual wellness visit. Here’s why that’s so important, and what to expect.

Maybe it’s part of your morning routine. You take a few prescription medications from the bottles on your kitchen table that you know keep you healthy.  

But you’re also aware that sometimes pills can cause problems if they’re taken together. Or they can interact with over-the-counter medications or supplements. And you may even wonder if you still need to take some of them.  

The best way to know for sure? Talk with your primary care doctor about the prescription medications you’re taking at your annual wellness visit (AWV).1 As part of this check-in, your doctor will look over your medications, check for any interactions and talk to you about side effects. AWVs are free as long as you’ve been on Medicare for at least a year.1  

Not taking advantage of this perk? It’s a missed opportunity to take charge of your health, says Helen Mitropoulos, MD. She’s an internal medicine physician at Optum in Glendale, California. 

“Assessing medications annually can go a long way toward preventing complications down the road,” she says. “That includes kidney failure from drug interactions and hospital admission from severe side effects. And even just quality-of-life changes because you’re not as healthy as you could be.” 

If you’ve already scheduled your AWV, you’re ahead of the pack. And you’ll get the most out of your appointment if you’re prepared to talk about your prescriptions. Here are some questions you can expect your doctor to ask when they review your medications.  

Question #1: Did you bring all of your pill bottles with you? 

Some people write down all their prescriptions before they go to a medication review. That’s good, but what’s better is to bring in your actual pill bottles, says Dr. Mitropoulos.  

The bottles provide a wealth of information for your doctor. This includes:2  

  • The name of the drug 
  • The dosage and how often you take it 
  • Date it was filled and how many refills are left 
  • The name of the prescribing doctor 
  • The name of pharmacy that filled the prescription 

So, to get ready for your review, round up all of your bottles, even the empty ones. Then put them in a bag to take with you. (Need a dedicated pill bag? Some Optum practices give them out to members, so check with your Optum health team.)  That way your doctor will have all the information they need, says Dr. Mitropoulos.  

A couple sitting on their couch reviewing the health care information on a laptop
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Question #2: Are you taking your medications as directed? 

Often, people simply forget to take pills. They might also avoid a medication because they don’t like the side effects, or they might worry about the cost.3 Your provider will want to know if any of those scenarios apply to you. If they do, now is the time to speak up.  

“It’s very important to be honest, because that makes a difference in your treatment going forward,” says Dr. Mitropoulos. “For example, if you’re not taking a prescribed medication because it’s too expensive or you don’t like the side effects, we need to know so we can find an alternative.” 

And remember that you can ask your doctor questions about medications at any other appointment too. Your doctor is always there to help. Your pharmacist is also a good resource.4 

Question #3: Are there new medications that have been prescribed since your last annual wellness visit? 

You might think every doctor you talk to would know what medications you’re taking. But that’s not always the case, says Dr. Mitropoulos.  

Let’s say you went to urgent care with lower back pain and were prescribed pain medication. Or you saw a specialist about a heart murmur, and now you have a new blood pressure drug.  

This information may not be available to every provider you speak with. That’s why your primary care provider may ask about any new medications that a specialist or other provider has prescribed, says Dr. Mitropoulos. The question helps your doctor catch potential drug interactions. 

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Question #4: Are you experiencing any side effects? 

It’s important to tell your doctor if you notice any changes in how you feel when you take your medications. Some side effects, such as dry mouth and upset stomach, are mild and go away with time. Or they disappear once you’re off the medication.5, 6   

Others can be more worrisome. For example, medications that cause you to feel drowsy or dizzy can increase your risk of falling.7 And if you fall, you can be seriously hurt. 

It can be tricky to pinpoint whether an issue is related to medication, points out Dr. Mitropoulos. Maybe you're getting frequent headaches or having trouble sleeping. Could these be side effects? Or do they just indicate that you need to manage stress better? 

When you notice things like this, write them down, says Dr. Mitropoulos. Then you can bring the list in to discuss during your medication review.  

There may be ways your doctor can reduce or eliminate side effects. In some cases, they may change your dosage or try you on a different medication.5,6 In other cases, your provider may decide it’s an unrelated problem. It could be a new symptom that your provider will want to look at. 

Question #5: Are you taking any vitamins, supplements or over-the-counter (OTC) medications? 

You may be surprised to learn that supplements can interact with prescription medications.8 So can OTC medications such as laxatives, cold medicine, pain relievers and allergy medications.5 Just because they’re sold over the counter does not mean they’re always safe, says Dr. Mitropoulos. 

Supplements and herbs have active compounds that could interfere with your medications.9 For example, the herb black cohosh may reduce how well statins work. (Statins are a type of medication that may help lower your cholesterol.) And St. John’s wort could interact with immunosuppressants.  

OTC medications may also cause issues. It may not be a good idea to take aspirin if you’re on a blood thinner, for example.5 And certain OTC cold medications may not be safe if you have high blood pressure.10  

To be double sure, check with the pharmacist if you're considering a supplement or OTC remedy. And talk with your doctor about all the medications you take, even the ones you only use sometimes.  

Question #6: Do you feel like your medications are keeping your health problems under control? 

The point of taking medications is to manage health issues. For example, you might take them to bring your blood pressure into a normal range.  

But if you still have high blood pressure, your medication isn’t working as it should. You may need to switch to another option. 

Part of your AWV involves taking an inventory of your health. “That includes your medications, but also how you’re managing each concern,” says Dr. Mitropoulos. “It’s a very important conversation that can help lead you to a healthier, happier life.” 

At Optum, our doctors take the time to understand how each of your medications works best for your health needs. Your Optum doctor or specialist can even suggest ways to get off of a medication, if possible. It’s all part of ensuring you’re on a safe, effective medication plan that helps you reach your health goals. 
 

Sources

  1. Medicare.gov. Yearly “wellness” visits. Accessed December 19, 2023. 
  2. Cleveland Clinic. Prescription medication labels: how to read. Last reviewed December 22, 2020. Accessed December 8, 2023. 
  3. American Medical Association. 8 reasons patients don’t take their medications. Published February 22, 2023. Accessed December 19, 2023.  
  4. National Institute on Aging. Taking medications safely as you age. Last reviewed September 22, 2022. Accessed December 19, 2023. 
  5. U.S. Food and Drug Administration. As you age: you and your medicines. Last updated February 19, 2019. Accessed December 19, 2023. 
  6. U.S. Food and Drug Administration. Finding and learning about side effects. Last updated August 8, 2022. Accessed December 19, 2023. 
  7. Mayo Clinic. Fall prevention: Simple tips to prevent falls. Updated February 3, 2022. Accessed December 19, 2023.  
  8. U.S. Food and Drug Administration. Mixing medications and dietary supplements can endanger your health. Last updated June 2, 2022. Accessed December 19, 2023.  
  9. National Center for Complementary and Integrative Health. Herb-drug interactions. Published July 2021. Accessed December 19, 2023.  
  10. Mayo Clinic. High blood pressure and cold remedies: Which are safe? Last updated April 12, 2023. Accessed December 19, 2023. 

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