· Executive Brief
National Check Your Meds Day 2026
Use the observance to review how people find information, enter the right route, and remain connected through follow-through.
Leadership signal
Recognition becomes useful when leaders inspect the real route.
The strongest use of the observance is operational. Map where questions enter, how requests move, when ownership changes, and how unresolved work becomes visible. The goal is not to make a clinical claim. It is to make the organization’s response easier to understand and manage.
Start by distinguishing what is known from what the organization still needs to learn. A campaign plan, communication volume, or meeting count does not establish that a route is usable. Leaders need direct listening, clear ownership, locally defined measures, and a method for keeping exceptions visible.
Executive opening
Medication review is a system responsibility, not a single visit
National Check Your Meds Day points to a problem that health systems already own. In U.S. national survey data, the share of adults taking five or more drugs at the same time rose from 8.2% to 17.1% between 1999 and 2018.[11] Polypharmacy was markedly more common among older adults and among people with heart disease or diabetes.[11] Those are the same patients who move most often between hospital, post-acute care, primary care and pharmacy.
The harm shows up at the front door. Across 60 U.S. emergency departments from 2017 to 2019, visits attributed to medication harms occurred at an estimated 6.1 per 1,000 population each year.[15] Of those visits, 38.6% ended in hospitalization.[15] The rate for people aged 65 years or older was 12.1 per 1,000, compared with 5.0 per 1,000 for younger people.[15] For a health system, those visits represent emergency capacity, inpatient beds and patient trust consumed by harm that review is meant to prevent.
The research on deprescribing, the planned reduction or stopping of medicines that no longer fit a patient’s goals, is encouraging but sobering. A meta-analysis of randomized trials in community-dwelling older adults found an average reduction of just 0.14 prescribed medications per person.[5] Stronger results appeared when review was built into electronic ordering prompts or a mentored reconciliation program.[4][14]
That is the executive point of this observance, and it is why the day deserves more than a reminder campaign. A medication review produces a list of recommendations. Value appears only when someone owns each recommendation, the prescriber acts on it, the patient understands it and the next setting receives it. Each of those steps can fail quietly, and none of them shows up in a count of reviews completed. The sections below add the evidence behind the live page’s operating guidance: burden and intervention effects, transitions, access, equity, workforce and communication.
Current evidence
What the research says about medication harm and deprescribing
Medication harm concentrates in drug classes that health systems already track. Among adults aged 65 years or older, therapeutic use of anticoagulants accounted for 4.5 emergency visits per 1,000 population, and diabetes agents for 1.8 per 1,000.[15] Overall, 69.1% of emergency visits for medication harms involved therapeutic use rather than misuse.[15] Most of this harm, in other words, comes from medicines taken as intended.
Interventions that reduce medication burden exist, but average effects are small. The community meta-analysis drew on 17 studies in 18 publications.[5] It pooled eight trials for its primary outcome and found a mean difference of −0.14 medications (95% CI, −0.27 to −0.01).[5] Across six trials, it found no significant reduction in the share of people prescribed at least one potentially inappropriate medication (odds ratio 0.92; 95% CI, 0.74 to 1.14).[5] Education alone has also struggled. A pragmatic cluster trial in 18 primary care clinics enrolled 3,012 adults aged 65 years or older with cognitive impairment who took five or more medications.[13] At six months, patients averaged 6.4 long-term medications with the intervention and 6.5 without it (P = .14).[13]
Results improve when the intervention is placed inside the prescriber’s workflow. A cluster-randomized trial enrolled 201 primary care physicians and 1,146 patients aged 65 years or older taking benzodiazepines, other sedative hypnotics or anticholinergic medications.[4] With an electronic health record precommitment approach, 36.8% of patients had at least one medication deprescribed, compared with 26.8% under usual care.[4] A second arm that used booster prompts reached 34.3%.[4]
Emergency care shows a similar pattern. A meta-analysis of 25 studies with 44,640 older participants found that pharmacist-led deprescribing was associated with a 32% reduction in potentially inappropriate medications (odds ratio 0.68).[8] Clinician education was associated with a 19% reduction in such prescribing (odds ratio 0.81).[8] Computerized decision support was associated with a 40% reduction in potentially inappropriate ordering (odds ratio 0.60).[8] Each of these estimates rests on only two or three studies, so the direction is more reliable than the size.[8]
For executives, the pattern matters more than any single estimate. Reviews that depend on goodwill and memory deliver modest change. Reviews connected to order entry, pharmacist capacity and a defined decision owner deliver more. The evidence supports funding the connection, not only the review. It also cautions against promising large reductions in medication counts from any one program.
Figure 1
Interest and recommendations are high; completed deprescribing is lower
Percent of patients or recommendations reaching a medication review step, as reported in each study. Values are copied from the cited studies [2], [4], [9]; none is estimated.
Data note. The first two values come from different studies, populations and definitions, so they are an indirect comparison; only the two trial arms from the same study can be compared directly.
Limitation. Stated interest is not a decision to stop, implementation was measured in a small Swedish sample, and the trial targeted sedative hypnotics and anticholinergic medications only.
Figure data (4 rows)
| Measure | Value | Population, setting and year as reported | Source |
|---|---|---|---|
| Older adults who want to stop at least one medication | 44% | 589 of 1,340 primary care patients aged 65 or older taking five or more medications, 14 countries, May 2022 to December 2023 | [9] |
| Pharmacist referral recommendations implemented in primary care | 77% | Of 48 assessable recommendations for 40 patients after hospital discharge, southern Sweden, 2021 to 2023, within six months | [2] |
| Patients with at least one medication deprescribed, usual care | 26.8% | Usual care arm of a cluster-randomized trial of 201 primary care physicians and 1,146 patients aged 65 or older, Massachusetts academic center, 2022 to 2024 | [4] |
| Patients with at least one medication deprescribed, EHR precommitment | 36.8% | Precommitment arm of the same trial; relative risk 1.40 versus usual care | [4] |
Continuum of care
Where medication changes are lost between settings
Transitions are where a medication plan is most easily broken. In a mentored quality improvement study at 18 North American hospitals from 2016 to 2018, teams could choose from 17 system-level and 6 patient-level interventions.[14] Across 4,947 sampled patients, unintentional medication discrepancies fell from 2.85 to 0.98 per patient during the intervention.[14] Time series analysis showed a 5% relative decrease per month beyond baseline trends (adjusted incidence rate ratio 0.95).[14]
That study also shows what implementation takes. Eight physician mentors supported the sites, with one to two site visits each.[14] Reconciliation improved when hospitals treated it as a managed program with outside coaching, not as a form inside the discharge packet. That distinction matters for budgeting, because coaching, audit and feedback are ongoing costs rather than a one-time launch.
Deprescribing can survive a transition when the plan travels with the patient. A randomized trial enrolled 372 adults aged 50 years or older taking five or more medications who were discharged to 1 of 22 post-acute care facilities.[12] Their mean age was 76.2 years, and 62% were female.[12] The intervention group had 14% fewer medications at facility discharge and 15% fewer at 90 days.[12] The hazard ratio for adverse drug events was 0.83, with a confidence interval that crossed 1 (95% CI, 0.52 to 1.30).[12] Medication reduction lasted, but the safety signal remained uncertain.
The handoff back to primary care is a weak link. A Swedish study reviewed hospital pharmacist referrals for 40 patients with 58 medication-related problems after discharge.[2] Three in four patients, 75%, had extensive polypharmacy, and adherence problems were the most common issue at 22%.[2] Reviewers judged 98% of the recommendations clinically relevant.[2] Of 48 assessable recommendations, 77% were implemented in primary care within six months.[2]
Relevance did not guarantee action. The association between clinical relevance and implementation was not statistically significant (odds ratio 2.27; p = 0.247).[2] Leaders should therefore measure whether recommendations are acted on in the receiving setting, not only whether they were written. These studies share a lesson for governance. Each improvement depended on a receiving team that knew a change had been made and why. Executives can make that expectation explicit. Post-acute partners and primary care practices can be asked to confirm receipt of each medication plan. Exceptions can then be reviewed at the same forum that reviews readmissions.
Figure 3
Why the pathway breaks
People
- Heavy clinical workloads and limited time for deprescribing conversations
- Unclear responsibility and authority to stop a medication started elsewhere
- Patient and clinician preference for keeping the current regimen
Process
- Recommendations sent without a named receiving prescriber
- Reconciliation treated as a discharge form rather than a managed program
- No defined follow-up after a review in emergency or post-acute care
Technology
- Deprescribing prompts absent from order entry
- No shared current medication list across settings
- Limited virtual review channels for people who cannot travel
Environment
- Multiple prescribers and settings for the same patient
- Wide variation in local deprescribing expectations
- Community pharmacy review not offered evenly across communities
Policy
- Incentive structures that do not reward deprescribing work
- Little specialized training or continuing education in deprescribing
- Program eligibility and offer practices that differ by race and ethnicity
Measurement
- Reviews counted, but implementation in the receiving setting not tracked
- Offers, completions and declines not stratified by population group
- Adverse drug events after changes not monitored
Unranked qualitative cause-and-effect diagram for the outcome in the box: Medication review recommendations for older adults with polypharmacy are not acted on, or are lost when the patient changes care settings Causes are assembled from the cited literature [2], [3], [4], [7], [9], [10], [12], [14]; categories are not weighted and their order carries no meaning.
Data note. Qualitative; no frequencies are implied.
Limitation. Causes drawn from published studies may not all apply locally; validate them with frontline teams.
Figure data (6 rows)
| Category | Causes drawn from the cited literature |
|---|---|
| People | Heavy clinical workloads and limited time for deprescribing conversations; Unclear responsibility and authority to stop a medication started elsewhere; Patient and clinician preference for keeping the current regimen |
| Process | Recommendations sent without a named receiving prescriber; Reconciliation treated as a discharge form rather than a managed program; No defined follow-up after a review in emergency or post-acute care |
| Technology | Deprescribing prompts absent from order entry; No shared current medication list across settings; Limited virtual review channels for people who cannot travel |
| Environment | Multiple prescribers and settings for the same patient; Wide variation in local deprescribing expectations; Community pharmacy review not offered evenly across communities |
| Policy | Incentive structures that do not reward deprescribing work; Little specialized training or continuing education in deprescribing; Program eligibility and offer practices that differ by race and ethnicity |
| Measurement | Reviews counted, but implementation in the receiving setting not tracked; Offers, completions and declines not stratified by population group; Adverse drug events after changes not monitored |
Access
Opening more than one door to a medication review
Emergency departments are where medication harm in older adults often becomes visible, as the national visit data show.[15] That makes the department a practical access point for review. The emergency care meta-analysis grouped programs into nine clinical pharmacist review studies with 28,360 participants and eight clinician education studies with 5,888 participants.[8] It also found one geriatrician teleconsultation study with 50 participants, four decision support studies with 9,462 participants and three fall-risk drug review studies with 880 participants.[8]
Virtual care can widen access for people who cannot easily travel. A 2026 cohort study evaluated a centralized pharmacist-led telehealth model that used home blood pressure readings for adults with uncontrolled hypertension.[1] Of 1,776 patients identified through outreach, 179 completed a pharmacist telehealth visit, and that group included more Black patients (53.1% vs 37.3%).[1] Those patients had greater systolic reductions at three months (-12.69 vs -5.69 mm Hg) and were more likely to pass the blood pressure control quality measure.[1] The evidence base is small, so virtual review is best treated as a channel to test, not a proven substitute.
Community pharmacy is another door, but it does not open evenly. Medicare Part D medication therapy management programs serve approximately 4.5 million eligible beneficiaries.[10] Black beneficiaries were less likely than White beneficiaries to receive a comprehensive medication review from a community pharmacist, while Asian beneficiaries were more likely.[10]
Patient demand is not the barrier many assume. Among 1,340 primary care patients aged 65 years or older taking five or more medications in 14 countries, 44% said they would like to stop at least one medication.[9] Interest ranged from 79% in Poland to 23% in Bulgaria.[9] Variation of that size suggests that local practice and expectations shape demand. An access plan should assume that many patients will accept a review if the offer is clear and the route is simple.
The access question for executives is whether every door reaches the same current medication list and the same accountable reviewer. Emergency, inpatient, post-acute, virtual and pharmacy routes each produce findings. Without a shared route, each finding risks staying where it was found. A practical test is to follow one recent review from each door. Did the recommendation reach a prescriber who could act on it, and did the patient hear the outcome?
Executive guidance · System route
Map the path from first contact to verified follow-through.
Use this route as a discussion framework. Replace each stage with the organization’s approved process, qualified roles, current service capacity, and applicable requirements. Do not infer a clinical protocol from the observance title.
The route at a glance
- Listen
- Clarify entry
- Coordinate the partner route
- Protect transitions
- Verify and learn
Reliability rule: Every stage needs a named owner, an observable status, an approved escalation path, and a defined signal that shows whether responsibility moved or remained unresolved.
Listen
Gather questions and friction points from people using the route, frontline teams, and community-facing staff. Separate observed barriers from assumptions.
Clarify entry
Publish a plain-language first step and identify who receives requests through each approved channel.
Coordinate the partner route
Align internal teams and external partners around one current message, real entry point, receiving owner, escalation path, and follow-through signal.
Protect transitions
Use acknowledgment and status visibility when responsibility moves between services, locations, or organizations.
Verify and learn
Review unresolved work, repeat contacts, and avoidable handoffs. Use the findings to improve the route rather than blame individuals.
Figure 2
The system route as one flow
The five stages of the system route described in this brief, drawn as one flow with a learning loop back to the start. The stages are the page’s original executive guidance, not a clinical protocol.
Data note. Shows sequence and handoffs only; it carries no counts or rates.
Limitation. Local processes may add, merge or reorder stages under organizational policy.
Figure data (5 rows)
| Stage | What the stage requires |
|---|---|
| Listen | Gather questions and friction points from people using the route, frontline teams, and community-facing staff. Separate observed barriers from assumptions. |
| Clarify entry | Publish a plain-language first step and identify who receives requests through each approved channel. |
| Coordinate the partner route | Align internal teams and external partners around one current message, real entry point, receiving owner, escalation path, and follow-through signal. |
| Protect transitions | Use acknowledgment and status visibility when responsibility moves between services, locations, or organizations. |
| Verify and learn | Review unresolved work, repeat contacts, and avoidable handoffs. Use the findings to improve the route rather than blame individuals. |
Equity and trust
Who is offered a review, and who is exposed to risk
Equity gaps in medication review begin before the review. Black and Hispanic Medicare beneficiaries were less likely than White beneficiaries to be offered a comprehensive medication review.[10] Asian, Hispanic, and North American Native beneficiaries were less likely to receive one after it was offered.[10] Black, Hispanic and Asian beneficiaries also waited longer between program enrollment and the offer.[10]
Exposure to risky prescribing follows a different pattern. One cross-sectional study analyzed 21,193,170 Medicare beneficiaries aged 65 years or older across more than 32 million beneficiary-years from 2016 to 2019.[7] It found that White beneficiaries consistently had higher rates of potentially inappropriate medication use.[7] Compared with White beneficiaries, high-risk medication use was 1.7 percentage points lower among Asian or Pacific Islander beneficiaries.[7] It was 3.4 points lower among Black beneficiaries and 0.6 points lower among Hispanic beneficiaries.[7] The authors suggest the gap may partly reflect differences in overall prescription use, and they recommend reducing inappropriate use across every group.[7]
Read together, these findings warn against a single equity metric. One group may be under-offered review while another is more exposed to high-risk drugs. Health systems need stratified data on both offer and exposure before deciding where to focus. They also need the same data for traditional Medicare, Medicare Advantage, Medicaid and commercial patients, because program rules shape who is offered a review.
Trust shapes the conversation in ways that are not always intuitive. In the 14-country survey, patients who were satisfied with their medications were less likely to want to deprescribe (odds ratio 0.31).[9] Trust in the general practitioner showed a small association in the same direction (odds ratio 0.960).[9] Patients and clinicians interviewed in a 2026 qualitative study described a lack of trust between physicians and patients as one barrier to deprescribing.[3] They also described communication breakdowns between disciplines.[3]
Trust therefore cuts both ways. A patient who trusts a clinician may defer to the current list rather than raise a concern. Review programs should invite questions explicitly, use interpreters and plain language, and track who declines a review and why. Protected, locally appropriate review of those patterns belongs on the equity agenda. The goal is not equal counts of reviews, but equal chances that a review ends in a decision the patient understands.
Human infrastructure
The people and time that medication review requires
Deprescribing is skilled work that competes with everything else in a clinical day. A 2026 qualitative study interviewed patients, physicians, pharmacists and nurses about deprescribing for older adults with polypharmacy.[3] Participants described multiple chronic conditions, complicated regimens, heavy workloads and limited time.[3] They also cited weak interdisciplinary communication, unclear responsibility and authority, and a preference for keeping the current regimen.[3] Concerns about safety and about whether treatment would remain effective after stopping a drug added to the hesitation.[3]
Institutional design was part of the problem. Participants reported little specialized training or continuing education in deprescribing, and incentive structures that did not reward it.[3] The authors called for better workflows, stronger interprofessional cooperation, standardized procedures, training and formal incentives.[3]
Where a specialist sits in the workflow matters. In a Jordanian hospital study of 128 patients older than 65 years, pharmacists compiled medication histories within 24 hours of admission from at least two information sources.[6] The study identified 151 medication discrepancies across intervention and control groups.[6] Of 52 pharmacist recommendations made to physicians, 49 (94.2%) were accepted or implemented.[6] At discharge, most unintentional discrepancies had been resolved (p < 0.001).[6]
Pharmacists do produce useful recommendations when the route exists. Hospital pharmacist referrals to primary care in the Swedish study were judged clinically relevant 98% of the time.[2] In emergency care, pharmacist-led deprescribing was associated with fewer potentially inappropriate medications.[8] Yet the same Swedish study found that only 77% of assessable recommendations were implemented after discharge.[2] The difference is the receiving end: a recommendation needs a prescriber with time, authority and a prompt to act. The electronic health record trial supplied that prompt, and more patients had a medication deprescribed.[4]
For workforce planning, the unit of capacity is the completed decision, not the pharmacist hour. Leaders should match pharmacist, nurse and technician time to the number of reviews the system expects. They should then confirm that prescribers have protected time and clear authority to accept or decline each recommendation. Mentoring and coaching also count as capacity. The 18-hospital reconciliation program relied on eight physician mentors to help local teams adopt new practices.[14]
Executive guidance · Operating dashboard
Measure whether the operating route works as intended.
Do not publish a number until the organization defines its numerator, denominator where relevant, owner, source system, exclusions, review cadence, and limits. The candidates below are management prompts, not benchmarks or reported results.
Four operating signals
Each signal pairs an executive question with one candidate local measure, set out below.
Executive guidance · Signal
Entry-point clarity
Can people and staff identify the approved first step without searching across conflicting instructions?
- Candidate local measure
- Locally defined contact, routing, and repeat-contact signals by channel and service.
Executive guidance · Signal
Ownership reliability
Does a specific team accept each request and make its status visible?
- Candidate local measure
- Requests without an owner, aged work, transfers, and escalations using locally approved definitions.
Executive guidance · Signal
Partner-route reliability
Do participating teams share one current route and understand who owns each dependency?
- Candidate local measure
- Locally defined conflicting instructions, unaccepted handoffs, unresolved dependencies, repeat contacts, and partner feedback.
Executive guidance · Signal
Improvement closure
Does the organization correct recurring friction and report what changed?
- Candidate local measure
- Selected barriers, assigned actions, completion status, and post-change review.
Figure 4
The operating system behind the dashboard
The four operating signals from this brief’s dashboard, each tied to the candidate owner named in the executive scorecard, around one accountable route. Drawn from the page’s original executive guidance.
Data note. Structural diagram; no measured values.
Limitation. Owners are candidates to be confirmed locally.
Figure data (4 rows)
| Operating signal | Candidate owner |
|---|---|
| Entry-point clarity | Executive sponsor and operational lead |
| Ownership reliability | Operational owner and participating teams |
| Partner-route reliability | Sending and receiving owners |
| Improvement closure | Improvement owner and executive sponsor |
Executive guidance · Handoff workflow
Keep work owned when it crosses a boundary.
A handoff is reliable only when the sending party knows who is expected to receive the work, the receiving party acknowledges responsibility, and any unresolved exception remains visible. Local policy and qualified judgment control the actual process.
How responsibility moves
Lane A
From message to accepted ownership
- Confirm the approved message and intended audience.
- Publish the actual entry point and receiving role.
- Acknowledge receipt using the locally approved method.
- Escalate when ownership or response remains unclear.
Lane B
From accepted ownership to verified follow-through
- Record the next accountable owner and visible status.
- Name the sending and receiving owners, shared information, current status, and unresolved dependency.
- Keep unresolved work visible across boundaries.
- Confirm closure or document the continuing exception.
Executive guidance · Executive scorecard
Ask questions that connect intent, ownership, and results.
The scorecard keeps review focused on decisions. Leaders should set definitions locally, examine variation without overclaiming cause, and pair quantitative signals with the experience of people who use and operate the route.
Who reviews what
- Executive sponsor and operational lead
- Operational owner and participating teams
- Sending and receiving owners
- Improvement owner and executive sponsor
Candidate owners named in the scorecard, confirmed locally.
| Operating signal | Executive question | Candidate owner | Suggested review point |
|---|---|---|---|
| Entry-point clarity | Can people and staff identify the approved first step without searching across conflicting instructions? | Executive sponsor and operational lead | At campaign launch and close |
| Ownership reliability | Does a specific team accept each request and make its status visible? | Operational owner and participating teams | At a locally defined cadence |
| Partner-route reliability | Do participating teams share one current route and understand who owns each dependency? | Sending and receiving owners | At a locally defined cadence |
| Improvement closure | Does the organization correct recurring friction and report what changed? | Improvement owner and executive sponsor | Until action is verified |
Figure 5
Control points for a reliable medication review and deprescribing pathway
| Control point | Risk if missing | Owner | Evidence of control |
|---|---|---|---|
| Structured medication reconciliation at admission and discharge | Unintentional discrepancies travel with the patient | Chief medical officer with pharmacy and nursing leaders | Discrepancies per patient on audited samples, trended monthly |
| Named receiving prescriber for every review recommendation | Relevant recommendations are never acted on | Primary care medical director | Share of recommendations accepted, declined or pending at 30 and 90 days |
| Deprescribing plan included in post-acute handoff | Reductions made in hospital are reversed in the next setting | Post-acute network lead and hospital medicine lead | Medication count and plan adherence at facility discharge |
| Deprescribing prompts in order entry for high-risk drug classes | Opportunities missed during routine prescribing | Chief medical information officer | Prompt reach, action rate and monitored adverse events |
| Stratified review of offers, completions and declines | Gaps in who is offered a review stay hidden | Chief health equity officer with pharmacy leadership | Offer and completion rates by race, ethnicity, language and payer |
| Pharmacist and prescriber capacity matched to review volume | Consultant recommendations queue without decisions | Chief pharmacy officer and chief nursing officer | Reviews completed and decisions recorded per available hour |
| Public observance messaging matched to a staffed route | People stop medicines on their own or cannot reach a reviewer | Chief communications officer with pharmacy lead | Response time and completion for requests generated by the campaign |
Control points derived from the cited evidence [2], [3], [4], [6], [10], [12], [14] and this brief’s executive guidance.
Data note. Each row is a control to verify, not a measured result.
Limitation. Owners and evidence of control must follow local policy and applicable requirements.
Public communication
Talking with patients and the public about stopping medicines
Most older adults are satisfied with their medicines, yet many are open to stopping one. In the 14-country survey, 82% of patients were satisfied with their medications.[9] At the same time, 44% wanted to deprescribe at least one.[9] The medicines most often named were diuretics (11%), lipid-modifying agents (11%) and agents acting on the renin-angiotensin system (8%) among 1,002 medications.[9] These are common, long-term therapies, which means the conversation about stopping one usually belongs in primary care with a clinician who knows the full history.
That combination calls for an invitation, not a warning. Observance messaging should never imply that people stop medicines on their own. A better message asks people to bring every medicine, including over-the-counter products, to a scheduled review through an approved channel. It also tells them who will follow up. Staff messages should carry the same promise, so that a pharmacist, nurse or front desk team member can name the next step when a person asks.
Education materials help, but they rarely carry change alone. In the cluster trial of patients with cognitive impairment, 30.5% of the intervention group and 29.6% of the control group had at least one potentially inappropriate medication at baseline.[13] At six months the share was 17.8% with education and 20.9% without it (P = .08).[13] Clinician education in emergency care was associated with a 19% reduction in potentially inappropriate prescribing.[8] The stronger electronic health record results came from asking clinicians to commit in advance, which is a communication strategy aimed at prescribers.[4]
How people take their medicines deserves equal attention. Adherence problems were the most common medication-related issue in hospital pharmacist referrals after discharge.[2] Public communication should therefore cover how to take medicines and how to raise a concern, not only which medicines might be stopped. Plain language, interpreter access and large-print materials make that message usable for more people.
Every public message should match the real route. If the observance invites people to check their medicines, the organization should know who answers that request, how quickly and through which channel. Requests generated by the campaign should be counted and closed like any other referral. Communication that outruns capacity puts at risk the trust that deprescribing depends on.
Executive guidance · 90-day plan
Move from listening to a verified improvement in 90 days.
The time boxes below are a management framework, not a clinical timeline. Adjust them to risk, scope, governance, resources, stakeholder participation, and applicable review requirements.
Ninety days, three moves
- Days 1–30See the current route
- Days 31–60Build the reliable path
- Days 61–90Make the change visible
Days 1–30 · Listen and map
See the current route
- Name an executive sponsor and an operational owner.
- Listen to people using the route and representative frontline teams.
- Map how National Check Your Meds Day communications connect to real entry points, owners, transitions, and escalation.
- Select one recurring barrier that the organization can responsibly address.
Days 31–60 · Design and test
Build the reliable path
- Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal.
- Validate the design with every sending and receiving team involved.
- Test one internal or partner handoff and correct a verified communication, dependency, or ownership gap.
- Test the route in more than one representative setting or operating period where practical.
Days 61–90 · Implement and verify
Make the change visible
- Launch the redesigned route with a small set of locally defined measures.
- Review unresolved work and recurring friction using a learning approach.
- Correct implementation barriers and record who owns each remaining dependency.
- Report what changed, what evidence was reviewed, and what still requires live oversight.
Figure 6
The 90-day plan on one timeline
The 90-day plan from this brief drawn as a timeline: each action sits in the 30-day window the plan assigns it. The full wording of each action is in the figure data and in the plan above.
Data note. Time boxes are a management framework, not a clinical timeline.
Limitation. Durations are uniform 30-day windows; real tasks may span windows.
Figure data (12 rows)
| Window | Action |
|---|---|
| Days 1–30 · Listen and map | Name an executive sponsor and an operational owner. |
| Days 1–30 · Listen and map | Listen to people using the route and representative frontline teams. |
| Days 1–30 · Listen and map | Map how National Check Your Meds Day communications connect to real entry points, owners, transitions, and escalation. |
| Days 1–30 · Listen and map | Select one recurring barrier that the organization can responsibly address. |
| Days 31–60 · Design and test | Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal. |
| Days 31–60 · Design and test | Validate the design with every sending and receiving team involved. |
| Days 31–60 · Design and test | Test one internal or partner handoff and correct a verified communication, dependency, or ownership gap. |
| Days 31–60 · Design and test | Test the route in more than one representative setting or operating period where practical. |
| Days 61–90 · Implement and verify | Launch the redesigned route with a small set of locally defined measures. |
| Days 61–90 · Implement and verify | Review unresolved work and recurring friction using a learning approach. |
| Days 61–90 · Implement and verify | Correct implementation barriers and record who owns each remaining dependency. |
| Days 61–90 · Implement and verify | Report what changed, what evidence was reviewed, and what still requires live oversight. |
Executive guidance · Leadership close
Carry one accountable improvement beyond the campaign window.
Recognition matters. It becomes durable when leaders also listen, clarify the route, support the people operating it, close an identified gap, and report the result without claiming more than the evidence supports.
Leadership commitment
Listen to the people closest to the route, assign one barrier, and verify the change.
Executive action kit · Day observance
Turn National Check Your Meds Day into accountable action.
Use the observance to review how people find information, enter the right route, and remain connected through follow-through.
Leadership focus
Use this observance to examine trustworthy information, prevention access, and community connection. Select one verified barrier, assign an accountable owner, and carry the improvement beyond the campaign window.
Workforce lens
Ask whether staffing, role clarity, training, tools, workload, and escalation support the people operating the information, access, coordination, and follow-through pathway.
Patient and community lens
Make the approved first step clear. Test whether a person can move from information to an acknowledged next action without navigating conflicting instructions.
Equity and access lens
Review language, disability, transportation, digital access, geography, trust, and other barriers using protected feedback and locally appropriate data.
Five-minute briefing
Inspect the operating sequence
Listen with people using the pathway, frontline teams, operational leaders, and community partners. Find one a message, request, referral, or handoff that does not reach an accountable owner, then test the locally approved route from entry through acknowledged follow-through.
- Listen
- Clarify entry
- Coordinate the partner route
- Protect transitions
- Verify and learn
Leadership actions for this week
- Name an executive sponsor and frontline operating owner.
- Ask people using and operating the pathway where ownership becomes unclear.
- Test one representative route from first question to acknowledged next step.
- Select one barrier that can be corrected without overstating the evidence.
- Set a review date and define how completion will be verified.
Candidate measures
Define every numerator, denominator where relevant, owner, data source, exclusions, cadence, and limitation locally. These are management prompts, not external benchmarks.
- Locally defined contact, routing, and repeat-contact signals by channel and service.
- Requests without an owner, aged work, transfers, and escalations using locally approved definitions.
- Locally defined conflicting instructions, unaccepted handoffs, unresolved dependencies, repeat contacts, and partner feedback.
Department readiness checklist
- The public and staff entry points match the actual approved process.
- A specific role accepts each request, referral, or escalation.
- Handoffs include acknowledgment and a visible unresolved state.
- Language, disability, digital, transportation, and trust barriers receive explicit review.
- Communications do not introduce unsupported themes, statistics, or clinical advice.
- A named leader will review what changed after the observance.
Intended audiences
- Executive and Operational Leaders
- Public Health and Community Partners
Staff communication template
During National Check Your Meds Day, our organization will connect awareness with a practical review of the information, access, coordination, and follow-through pathway. Use approved information, identify the correct entry point, confirm ownership when work moves, protect privacy, and escalate unresolved barriers through local channels.
Community communication template
National Check Your Meds Day is an opportunity to share trustworthy information and make the next step easier to find. Use our approved channels for information and support. If a request changes hands, our goal is to keep ownership and follow-through visible.
Measurement worksheet
- Signal
- What observable condition will show whether the route works?
- Definition
- What is included, excluded, and counted?
- Owner
- Who reviews the signal and acts on exceptions?
- Cadence
- When will leaders review it?
- Equity check
- Which differences require protected, locally appropriate review?
- Closure
- What evidence will confirm the improvement was completed?
- Editorial review
- Completed
- Source records
- 2 listed under Authoritative resources
- Review standard
- Sourced facts remain separated from original executive guidance
- Clinical boundary
- No new statistical or clinical claim was added by this action kit
Sources and content boundary
Authoritative resources
- Observance source: physicianshealthnetwork.org
- 2026 healthcare observances calendar: healthgrades.com
Use note: All operating models, measures, scorecard questions, and action steps are original executive guidance. This article supports leadership planning and education. It does not replace clinical judgment, emergency procedures, legal advice, professional standards, organizational policy, or applicable federal, state, and local requirements.
Peer-reviewed references
References
Fifteen peer-reviewed sources, newest first. Each was individually verified through authenticated academic research databases. Bracketed numbers in the text link here; the original executive guidance on this page carries no citations because it is guidance, not a sourced claim. Sources last checked in those databases on .
- 1.Wolverton D, Liang D, Zhao L, Hill D, Henderson R, Foushee LL. Telehealth Intervention by Pharmacists Collaboratively Enhances Hypertension Management and Outcomes. American Journal of Managed Care. 2026;32(1):23-29. https://doi.org/10.37765/ajmc.2026.89868
- 2.Wickman K, Lenander C, Caleres G, Modig S. Safe Handover or Lost in Transition?—A Retrospective Evaluation of Pharmacist Referrals to Primary Care Following Hospital Discharge. Pharmacy. 2026;14(5):122. https://doi.org/10.3390/pharmacy14050122
- 3.Yang W, Li M, Wang Z, Liu Q, Jiang M, Tuo K, et al. A qualitative study on the challenges in deprescribing for elderly patients with polypharmacy. Frontiers in Medicine. 2026;13:1814732. https://doi.org/10.3389/fmed.2026.1814732
- 4.Lauffenburger JC, Sung M, Glynn RJ, Keller PA, Robertson T, Kim DH, et al. Electronic Health Record Intervention and Deprescribing for Older Adults: A Randomized Clinical Trial. JAMA. 2026;335(12):1060-1069. https://doi.org/10.1001/jama.2025.26967
- 5.Linsky AM, Motala A, Booth M, Lawson E, Shekelle PG. Deprescribing in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. JAMA Network Open. 2025;8(5):e259375. https://doi.org/10.1001/jamanetworkopen.2025.9375
- 6.Hammad EA, Khaled F, Shafaamri M, Amireh B, Arabyat R, Abu-Farha RK. Impacts of pharmacist-led medication reconciliation on discrepancies and 30-days post-discharge health services utilization in elderly Jordanians. PLOS ONE. 2025;20(4):e0320699. https://doi.org/10.1371/journal.pone.0320699
- 7.Raver E, Jung J, Carlin C, Feldman R, Retchin S, Xu W. Racial and Ethnic Differences in Potentially Inappropriate Medication Use Among Medicare Beneficiaries. JAMA Network Open. 2025;8(4):e254763. https://doi.org/10.1001/jamanetworkopen.2025.4763
- 8.Skains RM, Hayes JM, Selman K, Zhang Y, Thatphet P, Toda K, et al. Emergency Department Programs to Support Medication Safety in Older Adults: A Systematic Review and Meta-Analysis. JAMA Network Open. 2025;8(3):e250814. https://doi.org/10.1001/jamanetworkopen.2025.0814
- 9.Vidonscky Lüthold R, Jungo KT, Weir KR, Adler L, Asenova R, Ares-Blanco S, et al. Older Adults’ Attitudes Toward Deprescribing in 14 Countries. JAMA Network Open. 2025;8(2):e2457498. https://doi.org/10.1001/jamanetworkopen.2024.57498
- 10.Allen A, Hung A. Racial and ethnic disparities related to the Medicare Part D Medication Therapy Management Program. Journal of Managed Care & Specialty Pharmacy. 2024;30(6):609-616. https://doi.org/10.18553/jmcp.2024.30.6.609
- 11.Wang X, Liu K, Shirai K, Tang C, Hu Y, Wang Y, et al. Prevalence and trends of polypharmacy in U.S. adults, 1999–2018. Global Health Research and Policy. 2023;8(1):25. https://doi.org/10.1186/s41256-023-00311-4
- 12.Vasilevskis EE, Shah AS, Hollingsworth EK, Shotwell MS, Kripalani S, Mixon AS, et al. Deprescribing Medications Among Older Adults From End of Hospitalization Through Postacute Care: A Shed-MEDS Randomized Clinical Trial. JAMA Internal Medicine. 2023;183(3):223-231. https://doi.org/10.1001/jamainternmed.2022.6545
- 13.Bayliss EA, Shetterly SM, Drace ML, Norton JD, Maiyani M, Gleason KS, et al. Deprescribing Education vs Usual Care for Patients With Cognitive Impairment and Primary Care Clinicians: The OPTIMIZE Pragmatic Cluster Randomized Trial. JAMA Internal Medicine. 2022;182(5):534-542. https://doi.org/10.1001/jamainternmed.2022.0502
- 14.Schnipper JL, Reyes Nieva H, Mallouk M, Mixon A, Rennke S, Chu E, et al. Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study. BMJ Quality & Safety. 2022;31(4):278-286. https://doi.org/10.1136/bmjqs-2020-012709
- 15.Budnitz DS, Shehab N, Lovegrove MC, Geller AI, Lind JN, Pollock DA. US Emergency Department Visits Attributed to Medication Harms, 2017-2019. JAMA. 2021;326(13):1299-1309. https://doi.org/10.1001/jama.2021.13844
Claim-to-source matrix
What each source supports
Every sourced claim in the new sections maps to the references that support it, the section where it is used, and the limitation a reader should keep in mind. Original executive guidance carries no sources because it is guidance, not a finding.
| Claim group | Sources | Years | Used in | Limitation |
|---|---|---|---|---|
| Polypharmacy prevalence and trend among U.S. adults | [11] | 2023 | Executive opening | Cross-sectional national survey data through 2018; count-based definition of five or more drugs does not judge appropriateness. |
| Emergency department visits attributed to medication harms and drug classes involved | [15] | 2021 | Current evidence | Surveillance sample of 60 U.S. emergency departments, 2017 to 2019; excludes harm managed outside emergency care. |
| Effect of deprescribing interventions on medication counts and potentially inappropriate medications | [5] [13] | 2025, 2022 | Current evidence | Small pooled effects; trials varied in populations, interventions and outcome definitions. |
| Electronic health record and decision support approaches to deprescribing | [4] [8] | 2026, 2025 | Current evidence | Single academic center for the randomized trial; emergency studies were heterogeneous and few contributed to each pooled estimate. |
| Medication reconciliation improvement at hospital transitions | [14] | 2022 | Continuum of care | Quality improvement design without concurrent controls; hospitals self-selected and chose their own interventions. |
| Deprescribing carried from hospital through post-acute care | [12] | 2023 | Continuum of care | Single medical center network; adverse drug event effect imprecise. |
| Implementation of pharmacist referrals in primary care after discharge | [2] | 2026 | Continuum of care | Small retrospective study of 40 patients in one Swedish region. |
| Emergency, virtual and community pharmacy access routes to medication review | [1] [8] [10] | 2026, 2025, 2024 | Access | Telehealth evidence comes from one retrospective cohort comparing reached patients with those not reached or declining; Part D findings summarize program-level research. |
| Older adults’ interest in deprescribing and the role of satisfaction and trust | [9] | 2025 | Public communication | Survey of primary care patients in 14 countries with wide between-country variation; stated interest may not predict action. |
| Racial and ethnic differences in medication therapy management offers and potentially inappropriate medication use | [7] [10] | 2025, 2024 | Equity and trust | Medicare populations only; administrative data cannot show clinical appropriateness for each patient. |
| Workforce, workflow and institutional barriers to deprescribing | [3] [6] | 2026, 2025 | Human infrastructure | Qualitative interview study with undisclosed sample size; reconciliation study was a single-country hospital study of 128 patients. |
| Patient and clinician education as a deprescribing strategy | [8] [13] | 2025, 2022 | Public communication | Education effects were modest and not statistically significant in the primary care trial. |
About the author
Greg Wahlstrom
MBAHCM
President and Chief Executive Officer, The Healthcare Executive
View Greg’s profile©2014 – 2026 The Healthcare Executive. All rights reserved.