Telehealth Medication Reviews: How to Prepare and What to Ask

When you’re managing multiple medications - prescription, over-the-counter, or supplements - a medication review isn’t just a good idea. It’s a safety net. And when that review happens over video call, you need to be ready. Telehealth medication reviews are now standard in U.S. healthcare, with 78% of systems offering them by late 2024. But unlike an in-person visit where your doctor can check your skin, pulse, or how you walk, a virtual review relies on your preparation. If you show up unprepared, you could miss a dangerous interaction, a duplicate drug, or a side effect that’s been hiding in plain sight.

What Exactly Is a Telehealth Medication Review?

A telehealth medication review is a virtual appointment with a pharmacist or provider who goes through every pill, patch, and powder you’re taking. They check for duplicates, dangerous combinations, doses that are too high or too low, and whether you’re even taking them as prescribed. It’s not a quick check-in. It’s a full audit of your drug history - done over Zoom, Doxy.me, or another HIPAA-compliant platform.

This isn’t just convenience. Studies show it cuts adverse drug events by over 34% in older adults. One 2020 study found that in nursing homes, telehealth reviews reduced serious medication errors by nearly 29%. The catch? It only works if you show up with the right information. If you forget your vitamins or can’t explain why you’re taking that green pill, the review becomes guesswork.

How to Prepare Before Your Appointment

You wouldn’t walk into a doctor’s office without your insurance card. Don’t walk into a telehealth review without your meds. Here’s what you need to gather:

• All medications - prescriptions, OTC drugs (like ibuprofen or antacids), supplements (vitamin D, fish oil, melatonin), herbal remedies (turmeric, St. John’s wort), and even eye drops or inhalers. Put them all on the table in front of you.
• Dosage and frequency - Write down how much you take, how often, and at what time. Don’t rely on memory. Check the bottle labels.
• Pharmacy records - If you use multiple pharmacies, call each one and ask for a current list of your prescriptions. Many will email or text it to you.
• Side effects you’ve noticed - Dizziness? Fatigue? Trouble sleeping? Nausea? Write them down. Don’t wait for the pharmacist to ask.
• Questions you have - Jot them down ahead of time. You’ll forget them once the call starts.

A 2023 study in the Journal of Telemedicine and Telecare found that patients who brought their actual medications to the call improved review accuracy by 37.4%. Why? Because pills look different than they do on paper. That blue capsule you think is “the blood pressure pill” might be a generic version you didn’t recognize - or worse, it might be something completely different.

What to Ask During the Review

Don’t let the pharmacist lead the whole conversation. You’re the expert on how your body feels. Ask these five questions - they’re not optional.

1. “How will you verify my medication list against pharmacy records?” - Nearly half of all medication errors come from incomplete or outdated lists. Pharmacists use systems like Surescripts to pull data from pharmacies, but not all pharmacies report in real time. If they’re only going by what you say, they’re flying blind.
2. “What changes are you recommending, and who will tell my doctor?” - Only 63% of telehealth services have a built-in way to send recommendations to your primary care provider. If they don’t, you’ll have to do it yourself - and that’s where things fall through the cracks.
3. “Are any of these drugs interacting with each other?” - Even common combos like blood thinners and NSAIDs (ibuprofen, naproxen) can cause internal bleeding. Or mixing statins with grapefruit juice can spike your risk of muscle damage. Ask for the top 3 risks.
4. “How will you monitor for side effects between visits?” - Virtual reviews can’t catch a rash or swelling between appointments. Ask if they’ll set up a follow-up check-in, or if you should call if you feel worse.
5. “Is there a cheaper or safer alternative?” - Some meds cost hundreds a month. Others have generics that work just as well. Pharmacists know which ones are worth switching to - but they won’t bring it up unless you ask.

These aren’t just questions. They’re your safety checklist. If the pharmacist can’t answer any of them clearly, push back. You’re not being difficult - you’re being smart.

What They Can’t Do Virtually

Telehealth is powerful - but it’s not magic. There are limits.

For example, if you’re on multiple psychiatric meds, the pharmacist can’t see if you’re trembling, slurring your words, or showing signs of confusion. A 2021 study found telehealth reviews were only 43.6% effective for psychiatric drug management without in-person mental status exams.

Same goes for elderly patients with polypharmacy. If you’re taking 10+ drugs, and you’re forgetting to take them, a video call won’t catch that unless you show the pill organizer - and even then, it’s hard to tell if you’re actually swallowing them or just setting them out.

And if you have mobility issues, swelling in your legs, or skin changes from long-term meds, the pharmacist can’t feel your pulses or check for ulcers. In these cases, a hybrid approach - one virtual review plus one in-person visit every 6 months - is the gold standard.

Common Problems and How to Avoid Them

Here’s what goes wrong - and how to fix it before your appointment:

• Video freezes or audio cuts out - Test your connection 15 minutes before. Use Wi-Fi, not cellular. Close other apps. Have a backup phone ready.
• They don’t ask about supplements - Many pharmacists focus only on prescriptions. Say upfront: “I’m also taking turmeric, magnesium, and CoQ10. I need to know if those are safe with my other meds.”
• They don’t explain why a drug was removed - If they say, “We’re stopping this,” ask: “Why? Is it because of side effects? Cost? Or because it’s not working?”
• You leave without a written summary - Ask for a PDF or email summary of changes. Don’t trust your memory. Print it or save it on your phone.

One patient on Reddit shared: “My telehealth review caught three dangerous interactions my local pharmacy missed - but the video kept freezing during my blood pressure demo.” That’s the risk. You need both good tech and good prep.

What’s Changing in 2025

Telehealth medication reviews are getting more structured - and more regulated.

In November 2024, CMS finalized new billing codes: G2225 for full reviews ($142.37) and G2226 for targeted ones ($78.92). This means more pharmacists can afford to offer them long-term. Also, as of January 2025, the DEA allowed certain controlled substances (Schedule III-V) to be managed entirely via telehealth - but only if you’ve had an initial in-person visit.

And now, 46 states require live video for controlled substance reviews. No phone-only calls allowed. That’s a big shift from 2020, when everything was relaxed during the pandemic.

Future tools will include remote monitoring: smart pill bottles that track when you open them, wearables that send blood pressure or heart rate data directly to your pharmacist. But for now, your best tool is still your phone, your meds, and your questions.

Who Should Skip Telehealth Reviews?

Not everyone is a good fit.

If you’re over 75 and not tech-savvy, a telehealth review might feel overwhelming. A 2024 survey found seniors without digital training were 30% less likely to complete a virtual review successfully. If that’s you, ask for help - a family member, a community health worker, or even a pharmacy tech who can walk you through the setup.

If you’re newly diagnosed with a complex condition - like heart failure, kidney disease, or bipolar disorder - you need face-to-face monitoring. Telehealth is great for maintenance, not diagnosis.

If you’re in crisis - suicidal thoughts, severe confusion, or sudden weakness - call 988 or go to the ER. No video call can replace urgent care.

Final Checklist Before Your Call

Use this before you hit “Join Meeting”:

• ✅ All medications in one place (bottles, boxes, or photos)
• ✅ List of doses and times written down
• ✅ List of side effects you’ve noticed
• ✅ List of 3-5 questions you want answered
• ✅ Stable internet and working camera
• ✅ Quiet space with no distractions
• ✅ Backup plan (phone number of your doctor, pharmacy, or a friend who can help)

That’s it. No fancy tech. No special training. Just preparation.

Telehealth medication reviews aren’t about replacing doctors. They’re about giving you more control - and more safety. You’re not just a patient. You’re the manager of your own meds. And if you show up ready, you’ll walk away with fewer risks, fewer surprises, and better health.