Before starting any new medication ask:

  • Are there underlying causes for the issues or symptoms the patient is experiencing that should be addressed first?

  • Is the new medication/treatment necessary for the patient's condition?

  • Are there nonpharmacologic therapies that can be considered?

  • Are there preventive measures that can be tried first?

  • Are there benefits? Are there proven outcomes? When will the benefit be seen?

  • What are the risks?

  • What are the patient's/caregiver's goals of therapy?

  • What are my goals (as the primary care physician) of therapy?

  • What is the patient's estimated life expectancy when considering age and comorbidities?

  • Have I discussed this with the patient for shared decision-making?

  • Is the patient adherent to currently prescribed medications? Can the patient adhere to this medication? Consider the complexity of regimen and any visual, dexterity, or cognitive impairments the patient has.

  • Can the patient afford this medication?

When starting any new medications, consider it a trial rather than a permanent addition.

  • Follow up with the patient in a timely manner after adding medications.

  • Assess for effectiveness and safety at follow-up visits.

When renewing refills, consider the benefits vs. the risks of continuation (long term and short term).