Making the most of a medication review

Reviews can feel short. You’ve lived weeks or months of days, and you have one appointment to describe them. Bringing what you’ve noticed, written down, means less depends on memory in the room.

What a review is for

NICE’s guideline on ADHD asks for ADHD medication to be reviewed at least once a year, by a healthcare professional with training and expertise in managing ADHD. The NHS page on methylphenidate says much the same: a review at least once a year, to make sure there are no problems.

NICE also lists what that review covers. Alongside your own preferences, it includes the benefits of treatment, “including how well the current treatment is working throughout the day”. It includes side effects, the impact on education and employment, and, if ADHD symptoms still cause significant difficulties once medication has been optimised, whether you need other kinds of support, such as psychological, educational or social support.

That list makes a useful map for your notes. Much of it is something you know about first-hand, from days nobody else in the room saw.

Guidance also describes regular checks alongside reviews. NICE asks for heart rate and blood pressure to be monitored every 6 months and before and after each dose change, and for adults taking ADHD medication to have their weight measured every 6 months.

What to bring

Notes beat memory. A few honest lines over a few weeks say more than trying to recall everything on the spot.

Useful things to have with you: when you took each dose, and roughly when you noticed it kicking in and wearing off; any side effects, with roughly when they happened; how sleep and appetite have been; and how work, study and home life have gone.

Bring the parts that have been hard to keep up with, too. NICE guidance recognises that ADHD symptoms can make it hard to stick to treatment plans, giving the example of “remembering to order and collect medication”. That’s worth saying out loud, without apology.

MedlinePlus suggests keeping a written list of all the medicines you take, including ones bought without a prescription, and bringing it each time you visit a doctor.

Write your questions down before you go. In the room, it’s easy for them to slip away, and easy to remember the important one on the bus home.

And if you’d like company, NICE guidance asks professionals to check whether adults with ADHD would like a partner, close friend or carer to join discussions on treatment.

Say what matters early

If something is worrying you, bring it up near the start of the appointment rather than at the door. It’s easier to give it the time it needs.

Your view counts. NICE guidance asks healthcare professionals to regularly discuss with people with ADHD how they want to be involved in treatment planning and decisions. If you’re not sure what something means for you, it’s fine to ask, and fine to ask for it in writing.

You don’t have to save everything for the yearly review, either. The NHS says to tell your doctor if common side effects bother you or don’t go away.

Before you leave, check you know what was agreed, and get anything new written down. NICE guidance mentions clear instructions about how to take a medicine, in picture or written format, as one way to help people with ADHD keep to their treatment. It also mentions visual reminders such as apps, alarms, and notes on calendars or fridges.

Questions you might bring: what are you hoping to see in my notes? Is what I’m noticing something people commonly report? What would be most useful for me to keep track of before next time? When is my next check?

Your notes are a record of your days. A review is a good place for them.

How Trace can help

Trace’s report for a medication review gathers what you’ve logged onto a page or two: the days you logged a dose, the times you noted it kicking in and wearing off, side effects you logged and how often, the tags that showed up on good and hard days, notes you’ve starred, and your questions.

It shows things as you entered them. It doesn’t interpret them, and it doesn’t tell anyone what they mean. That part is a conversation between you and your prescriber.

If you add an appointment to Trace, it reminds you to get your report ready a couple of days before, while there’s still time to add a question or two.

You can share it or print it before an appointment. Brain dumps you star along the way end up on it too, so a thought at eleven on a Tuesday night doesn’t get lost by the time you’re in the room.

General information, not medical advice. Talk to your prescriber or doctor about your own treatment. How we write

Spot a mistake? Write to us at hello@trace-adhd.com