Why medication changes may need provider review

Best first step: Tell the care team what medication you want changed, what is happening now, and whether the concern involves side effects, safety, missed doses, discharge timing, or running out of medication.

• Medication changes may need provider review for safety, diagnosis, side effects, interactions, refill timing, or discharge planning.
• Do not stop, restart, double, skip, or change medication because of a portal mismatch without checking first.
• A pharmacy can answer many medication questions, but some changes must be approved by a prescriber.
• Provider review may be needed before changing controlled medications, sedating medications, psychiatric medications, or medications with taper instructions.
• After discharge, refill or change requests may need to go through Brookhaven, an outpatient prescriber, primary care, psychiatry, or another follow-up provider.
• Urgent side effects, allergic reactions, overdose concerns, withdrawal concerns, or unsafe thoughts should be handled immediately, not through a routine portal request.

Reason for review	What the provider may consider
Safety	Whether the change could increase sedation, agitation, falls, confusion, withdrawal, overdose risk, or unsafe thoughts.
Side effects	Whether symptoms may be medication-related and whether the dose, timing, or medication should be adjusted.
Interactions	Whether the medication interacts with other prescriptions, over-the-counter products, supplements, alcohol, cannabis, or sedatives.
Diagnosis and symptoms	Whether the requested change fits the patient’s current symptoms, diagnosis, and treatment goals.
Discharge planning	Whether the medication can be safely continued, monitored, refilled, and followed after discharge.
Follow-up responsibility	Whether Brookhaven or an outpatient provider should manage the medication after care ends.

• Starting a new medication.
• Stopping a medication.
• Restarting a medication that was stopped during care.
• Changing the dose or how often it is taken.
• Changing the time of day a medication is taken.
• Switching from one medication to another.
• Requesting early refill, bridge supply, or discharge refill.
• Changing a medication because of side effects.
• Changing a medication because symptoms worsened or returned.
• Changing medication instructions that do not match the portal, bottle, or discharge paperwork.

Review area	Examples
Current medication list	What the patient is taking now, what was stopped, what changed, and what appears in the portal.
Symptoms and safety	Mood, sleep, anxiety, agitation, unsafe thoughts, confusion, withdrawal symptoms, or medical symptoms.
Medication response	Whether the medication is helping, causing side effects, or not working as expected.
Pharmacy details	Pharmacy location, insurance or prior authorization, refill status, supply issues, or prescription receipt.
Follow-up care	Who will monitor the medication after discharge and when the next appointment happens.
Support needs	Whether a support person should help with pickup, storage, reminders, or monitoring side effects.

Important: A portal refill button or pharmacy request does not always mean the medication can be changed, restarted, or refilled automatically.

• The medication may require a current provider review.
• The medication may have been stopped during Brookhaven care.
• The medication may need taper instructions.
• The refill may require follow-up appointment confirmation.
• The pharmacy may need clarification from the prescriber.
• The portal may show older medication history instead of the current plan.
• The medication may be managed by an outpatient provider after discharge.

• Tell nursing staff about side effects or new symptoms.
• Ask when the provider will review medication questions.
• Ask whether medication changes affect therapy, sleep, safety checks, or activity access.
• Ask which medications are temporary and which may continue after discharge.
• Ask whether home medications were continued, stopped, or replaced.
• Ask whether the discharge medication list will include the final instructions.

After-discharge situation	What to do
Medication instructions are unclear	Compare the bottle, portal, and discharge list, then contact the care team or pharmacy before making changes.
Side effects started after discharge	Contact the care team, pharmacy, or follow-up prescriber. Seek urgent help for severe symptoms.
Medication is running out	Request review before the medication runs out and confirm who manages refills.
Patient wants to stop medication	Contact the prescriber first. Some medications should not be stopped suddenly.
Symptoms returned or worsened	Ask for clinical guidance. Use urgent support if symptoms affect safety or functioning.

Do not wait for a routine portal reply if symptoms are severe, sudden, allergic, unsafe, or medically urgent.

• New rash, swelling, trouble breathing, or possible allergic reaction.
• Severe sedation, confusion, fainting, chest pain, or severe dizziness.
• Worsening thoughts of self-harm, harm to others, or unsafe urges.
• Severe agitation, restlessness, panic, hallucinations, or unusual behavior changes.
• Overdose concern, withdrawal concern, or taking more medication than prescribed.
• Medication instructions that conflict with discharge paperwork.
• Running out of medication before the follow-up appointment.

Important: A support person can share concerns with Brookhaven, but Brookhaven may not be able to share medication information back unless the patient has authorized it or legal authority applies.

• Ask whether the patient has authorized medication-related updates.
• Ask what the support person can see in the portal.
• Ask whether the support person can help with pharmacy pickup.
• Ask what warning signs the support person should watch for, when allowed.
• Ask who should be contacted if the patient wants to change or stop medication.

• Patient full name and date of birth.
• Medication name, dose, and instructions.
• Whether the medication was new, changed, stopped, or continued during Brookhaven care.
• What change is being requested.
• Why the change is being requested.
• Any side effects, symptoms, missed doses, extra doses, or safety concerns.
• What the discharge paperwork says.
• What the portal, pharmacy, or bottle says.
• Preferred pharmacy and phone number.
• Whether the medication will run out soon.
• Best callback number.

Do not wait for a portal reply if the medication concern affects immediate safety, severe symptoms, allergic reaction, suspected overdose, withdrawal concern, severe confusion, missed critical medication, or thoughts of self-harm or harm to others.

• If symptoms are severe or sudden, seek urgent medical help.
• If there is trouble breathing, swelling, chest pain, fainting, severe confusion, or suspected overdose, use emergency services.
• If the patient has thoughts of self-harm, harm to others, or feels unsafe, seek immediate help.
• If the medication is missing from the pharmacy and the patient will miss an important dose, call the pharmacy and care team directly.
• If the patient is still at Brookhaven, tell the assigned nurse or nearest staff member immediately.