Doctor Medication Reconciliation Note
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Create a medication reconciliation documentation for patient at [transition point].

Transition details (placeholders):
- Transition: [admission/discharge/transfer]
- From: [home/hospital/SNF]
- To: [hospital/home/SNF]
- Medications: [use placeholder list]
- High-risk medications present: [anticoagulants/insulin/opioids]

MEDICATION RECONCILIATION

RECONCILIATION PROCESS
1. Obtain medication list from: [patient/family/pharmacy/records]
2. Compare to current orders
3. Identify discrepancies
4. Resolve with prescribing physician
5. Document and communicate

MEDICATION LIST TEMPLATE

For each medication:
- Generic name: []
- Brand name: [if relevant]
- Dose: [amount]
- Route: [oral/topical/inhaled/IV]
- Frequency: [schedule]
- Indication: [why taking]
- Last dose: [date/time]
- Continue/hold/modify/discontinue: [decision]
- If changed: reason: []

HIGH ALERT MEDICATION REVIEW

ANTICOAGULANTS
- Drug: [warfarin/DOAC/heparin]
- Last INR if warfarin: [value/date]
- Indication: [Afib/DVT/PE/valve]
- Bridge needed: [yes/no]
- Hold for procedures: [yes/no]

INSULIN
- Type: [basal/bolus/correction]
- Home doses: []
- Hospital regimen: [may differ]
- Hypoglycemia protocol: [in place]

DISCREPANCIES FOUND
| # | Medication | Discrepancy | Resolution | MD Notified |
| 1 | [] | [] | [] | Yes/No |

PATIENT EDUCATION
- Medication changes explained: [yes]
- Patient/family verbalized understanding: [yes]
- Written list provided: [yes]
- Pharmacy follow-up: [recommended]

Note: Medication reconciliation must be performed by licensed clinician — placeholder information only

Source: https://promptzyo.com/prompt/doctor-medication-reconciliation-note