Checklist/Tool

Pharmacy check: medication reconciliation after stroke (prevent duplicates + interactions)

A step-by-step checklist to reconcile hospital discharge meds with home meds, avoid duplicates, and catch interaction risks—plus a short script for the pharmacist

Secondary PreventionCaregiver, EveryoneIntro12 minPlain (6–8)

Educational only

Educational only — do not stop or change medicines without clinician/pharmacist confirmation.

Get help now

For severe bleeding, chest pain, trouble breathing, fainting, or new stroke-like symptoms: call your local emergency number immediately.

What you'll learn

  • Create one accurate ‘current meds’ list
  • Identify duplicates and stop/continue changes
  • Ask the pharmacist the 5 key questions

Key insight

Ask the pharmacist the 5 key questions

Bring these

  • Discharge med list
  • All pill bottles
  • OTC + supplements
  • Allergies list

Reconcile (line-by-line)

  • What was stopped?
  • What is new?
  • What dose changed?
  • What is temporary (duration)?

Duplicate traps

  • Two statins
  • Two blood pressure meds same class
  • Two antiplatelets without clear plan

5 pharmacist questions

  • Any interactions with my stroke meds?
  • Bleeding risk warnings?
  • Best time of day?
  • What side effects are urgent?
  • What labs/follow-up are needed?

After the visit

  • Update the master med list
  • Update the pill organizer
  • Share the updated list

Practice check

Check your understanding

A few untimed questions. Pick an answer to see instant feedback, then continue to the next lesson.

0 of 3 answered

Question 1

1. Medication reconciliation means:

Question 2

2. A good item to bring is:

Question 3

3. A key question is:

References

  1. AHRQ logo