A repeat prescription list tells you what a patient is issued. It does not tell you what they take, and it is silent on the one thing that usually explains the consultation: the drug that used to be there.
So when a list looks unexpectedly short, or a patient's control has drifted without a clear reason, ask directly what they have stopped and when. Patients rarely volunteer it, partly because stopping felt like their decision rather than a clinical event, and partly because they expect to be told off. Asking without a note of accusation — what did you stop, and what happened that made you stop it — usually produces a side effect nobody recorded, a cost they did not want to mention, or a sentence from another clinician that was heard differently from how it was meant.
The same applies to drugs stopped in hospital. A medication paused for a procedure and never restarted is one of the commonest avoidable causes of deterioration after discharge, and it is invisible unless somebody compares the discharge list against the one before admission.
- Ask what has been stopped and when, not just what is being taken
- Ask what happened that prompted stopping — the answer is usually clinical
- Compare the discharge medication list against the pre-admission list at the first review
- Record the reason a drug was stopped, so the next clinician does not simply restart it
Why it matters
A drug that silently disappeared explains more consultations than any drug that is still on the list.
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