After an operation: how to organise your new and usual medication

When you get home after surgery, combining your new and usual medication into a single plan avoids duplicates, missed doses and restarting things by mistake.

To organise your medication after an operation, compare everything you have at home with the discharge report, put away anything that has been stopped, make a single list with times and end dates, and book an appointment with your GP in the first week to review it. That way you avoid taking the same thing twice or restarting a withdrawn medicine by mistake.

Here is what to ask before you leave hospital, how to organise your doses at home and what precautions to take with painkillers.

Why is this a delicate time for your medication?

Because when you leave hospital, new medicines, others that have been temporarily stopped and your usual ones all come together, often with dose changes. The Spanish Ministry of Health prioritises what is called medicines reconciliation after discharge to avoid errors such as restarting at home a medicine that had been withdrawn.

In the first few days you may also be tired, in pain or less mobile, which makes mistakes easier. These are also the days when you may be taking more "high-risk" medicines, such as opioid painkillers or anticoagulants, which the Ministry itself lists as high-risk medicines.

What should you be clear about before leaving hospital?

Before you go, make sure you understand what to take, what not to take and for how long. If anything in the discharge report is unclear, ask there and then: it is much easier to sort out in hospital than from home.

• Which medicines are new, what they are for and for how many days you should take them.
• Which of your usual medicines stay the same, which change dose and which are stopped, and whether that is temporary.
• Whether any will be restarted later, for example an anticoagulant or antiplatelet stopped before the operation, and who will tell you when.
• Which painkillers you can take, at what times and what to do if the pain is not controlled.
• Whether you need injections, for example to prevent blood clots, and who will give them or how you can learn to do them.
• Whether you have prescriptions for everything new or need to request them from your health centre.

How do you organise your new and usual medication at home?

The most useful thing is to bring everything together in a single list and a single system of doses, and to put away anything that has been stopped. That way you avoid doubling up on a medicine or carrying on with one you no longer need.

1. Take out all your medicines and compare them with the discharge report, one by one.
2. Put anything that has been stopped in a closed, labelled bag so you do not take it out of habit. If it has been stopped for good, take it to the SIGRE collection point at the pharmacy.
3. Write a new list with the time of each dose and the end date of temporary treatments. We explain how in your personal medication list.
4. Prepare your doses in a pill organiser or ask your pharmacy to help you organise them.
5. Book an appointment with your GP: the Ministry of Health recommends reconciling your medication preferably within the first week of receiving the discharge report, or in any case before a prescription for a new medicine is issued.

What precautions should you take with painkillers?

Take them as prescribed and do not combine different painkillers on your own initiative. If you have been prescribed opioids, MedlinePlus explains that drowsiness and impaired judgement are common, and advises not drinking alcohol, not driving or operating machinery, and storing them safely at home.

• For the constipation opioids cause, MedlinePlus advises more fluids, more exercise and fibre; ask your pharmacist before taking laxatives.
• Check you are not taking the same active ingredient twice: paracetamol, for example, is in many combination products.
• Do not keep leftover opioids "for next time": return them to the pharmacy.
• If you take other medicines that make you sleepy, mention it to your doctor or pharmacist.

If you need to get back behind the wheel soon, see our article on driving and medicines.

A practical example: Luis and his knee replacement

Let us take the case of Luis, 66, recently retired, who lives with his partner and normally takes medication for blood pressure, diabetes and cholesterol. He has a knee replacement and comes home with a discharge report that includes heparin injections for several weeks, an opioid painkiller, paracetamol and an instruction to temporarily stop one of his diabetes medicines.

At home, Luis compares his bag of medicines with the report and puts the paused diabetes medicine in a bag marked "Do not take until review". He writes a new list with times and the end date for the heparin, prepares the week's doses and books an appointment with his GP for that same week. At the appointment they review his treatment together and he is told when to restart the diabetes medicine. Luis manages everything himself, without depending on his partner.

How can IMA Health help?

After an operation, having your medication prepared according to the new regimen takes away one worry when you most need it. With IMA Health, a specialised pharmacy prepares your medication by day and time of each dose, including the changes your doctor makes, and delivers it to your home. IMA's personalised follow-up helps you keep track of which treatments end and which continue. For the first few days after discharge, also read hospital discharge with new medication.

Sources

• Spanish Ministry of Health: Recommendations on medicines reconciliation in primary care for people with chronic conditions (2022, in Spanish)
• MedlinePlus: Narcotic pain relievers (in Spanish)
• MedlinePlus: Risks of hip and knee replacement surgery (in Spanish)

This article is for information only and does not replace advice from your doctor or pharmacist.