My Medication

My Name is

It is important that I do not take

Date I filled this workbook in

This workbook has information about all the medications I am taking or using.
Medication can mean things like -

This booklet is for you to fill in with a list of all the
medication that you take.
You will be able to keep this workbook.
It is a good idea to fill in this workbook with your case manager or
some-one else that you trust.
It may be a good idea to write here the name of your Responsible Medical Officer
Write down the names of every medication that you take.

How to use this workbook

1.

3.

4.

5.

6.

7.

8.

2.

Things I need to know about taking my medication

Complete the next section for each medication that you take, so you have all the information for all of your medication.

Name of the medication 1.

What do I call it?
(morning one, pink one)

When do I take it?
(breakfast, lunch)

How much do I take?

What is this medication for?

How might this medication help me?

What will happen when I take this medication?

What will happen if I stop taking this medication suddenly?

Are there any other medications I must not take with this one

Medications can sometimes give me side effects

This is when medications can make you feel dizzy, or sick, or very sleepy.

These are the side effects I might get with this medication

These are the side effects I need to tell the doctor about

I may have had these side effects

This is what helped

How this medication may affect my life

These are the things I must not do when I am taking this medication

I need to go to the following appointments
(include hospital appointments)

I need to have these tests when I am taking this medication
(include how often the tests are done)

This medication also affects my life like this

Things I need to know about taking my medication

Complete the next section for each medication that you take, so you have all the information for all of your medication.

Name of the medication 2.

What do I call it?
(morning one, pink one)

When do I take it?
(breakfast, lunch)

How much do I take?

What is this medication for?

How might this medication help me?

What will happen when I take this medication?

What will happen if I stop taking this medication suddenly?

Are there any other medications I must not take with this one

Medications can sometimes give me side effects

This is when medications can make you feel dizzy, or sick, or very sleepy.

These are the side effects I might get with this medication

These are the side effects I need to tell the doctor about

I may have had these side effects

This is what helped

How this medication may affect my life

These are the things I must not do when I am taking this medication

I need to go to the following appointments
(include hospital appointments)

I need to have these tests when I am taking this medication
(include how often the tests are done)

This medication also affects my life like this

Things I need to know about taking my medication

Complete the next section for each medication that you take, so you have all the information for all of your medication.

Name of the medication 3.

What do I call it?
(morning one, pink one)

When do I take it?
(breakfast, lunch)

How much do I take?

What is this medication for?

How might this medication help me?

What will happen when I take this medication?

What will happen if I stop taking this medication suddenly?

Are there any other medications I must not take with this one

Medications can sometimes give me side effects

This is when medications can make you feel dizzy, or sick, or very sleepy.

These are the side effects I might get with this medication

These are the side effects I need to tell the doctor about

I may have had these side effects

This is what helped

How this medication may affect my life

These are the things I must not do when I am taking this medication

I need to go to the following appointments
(include hospital appointments)

I need to have these tests when I am taking this medication
(include how often the tests are done)

This medication also affects my life like this

Things I need to know about taking my medication

Complete the next section for each medication that you take, so you have all the information for all of your medication.

Name of the medication 4.

What do I call it?
(morning one, pink one)

When do I take it?
(breakfast, lunch)

How much do I take?

What is this medication for?

How might this medication help me?

What will happen when I take this medication?

What will happen if I stop taking this medication suddenly?

Are there any other medications I must not take with this one

Medications can sometimes give me side effects

This is when medications can make you feel dizzy, or sick, or very sleepy.

These are the side effects I might get with this medication

These are the side effects I need to tell the doctor about

I may have had these side effects

This is what helped

How this medication may affect my life

These are the things I must not do when I am taking this medication

I need to go to the following appointments
(include hospital appointments)

I need to have these tests when I am taking this medication
(include how often the tests are done)

This medication also affects my life like this

Things I need to know about taking my medication

Complete the next section for each medication that you take, so you have all the information for all of your medication.

Name of the medication 5.

What do I call it?
(morning one, pink one)

When do I take it?
(breakfast, lunch)

How much do I take?

What is this medication for?

How might this medication help me?

What will happen when I take this medication?

What will happen if I stop taking this medication suddenly?

Are there any other medications I must not take with this one

Medications can sometimes give me side effects

This is when medications can make you feel dizzy, or sick, or very sleepy.

These are the side effects I might get with this medication

These are the side effects I need to tell the doctor about

I may have had these side effects

This is what helped

How this medication may affect my life

These are the things I must not do when I am taking this medication

I need to go to the following appointments
(include hospital appointments)

I need to have these tests when I am taking this medication
(include how often the tests are done)

This medication also affects my life like this

Things I need to know about taking my medication

Complete the next section for each medication that you take, so you have all the information for all of your medication.

Name of the medication 6.

What do I call it?
(morning one, pink one)

When do I take it?
(breakfast, lunch)

How much do I take?

What is this medication for?

How might this medication help me?

What will happen when I take this medication?

What will happen if I stop taking this medication suddenly?

Are there any other medications I must not take with this one

Medications can sometimes give me side effects

This is when medications can make you feel dizzy, or sick, or very sleepy.

These are the side effects I might get with this medication

These are the side effects I need to tell the doctor about

I may have had these side effects

This is what helped

How this medication may affect my life

These are the things I must not do when I am taking this medication

I need to go to the following appointments
(include hospital appointments)

I need to have these tests when I am taking this medication
(include how often the tests are done)

This medication also affects my life like this

Things I need to know about taking my medication

Complete the next section for each medication that you take, so you have all the information for all of your medication.

Name of the medication 7.

What do I call it?
(morning one, pink one)

When do I take it?
(breakfast, lunch)

How much do I take?

What is this medication for?

How might this medication help me?

What will happen when I take this medication?

What will happen if I stop taking this medication suddenly?

Are there any other medications I must not take with this one

Medications can sometimes give me side effects

This is when medications can make you feel dizzy, or sick, or very sleepy.

These are the side effects I might get with this medication

These are the side effects I need to tell the doctor about

I may have had these side effects

This is what helped

How this medication may affect my life

These are the things I must not do when I am taking this medication

I need to go to the following appointments
(include hospital appointments)

I need to have these tests when I am taking this medication
(include how often the tests are done)

This medication also affects my life like this

Things I need to know about taking my medication

Complete the next section for each medication that you take, so you have all the information for all of your medication.

Name of the medication 8.

What do I call it?
(morning one, pink one)

When do I take it?
(breakfast, lunch)

How much do I take?

What is this medication for?

How might this medication help me?

What will happen when I take this medication?

What will happen if I stop taking this medication suddenly?

Are there any other medications I must not take with this one

Medications can sometimes give me side effects

This is when medications can make you feel dizzy, or sick, or very sleepy.

These are the side effects I might get with this medication

These are the side effects I need to tell the doctor about

I may have had these side effects

This is what helped

How this medication may affect my life

These are the things I must not do when I am taking this medication

I need to go to the following appointments
(include hospital appointments)

I need to have these tests when I am taking this medication
(include how often the tests are done)

This medication also affects my life like this

Medication Reviews

When you take medication you need to make sure you have regular reviews. A review is a chance for you and your doctor to check that the medication is working well for you.

Things I want to talk about at my next review
My question
Date:

What I found out
Date:

Things I want to talk about at my next review
My question
Date:

What I found out
Date:

Medication Reviews (continued)

Things I want to talk about at my next review
My question
Date:

What I found out
Date:

Things I want to talk about at my next review
My question
Date:

What I found out
Date:

Medication Reviews (continued)

Things I want to talk about at my next review
My question
Date:

What I found out
Date:

Things I want to talk about at my next review
My question
Date:

What I found out
Date:

Medication Reviews (continued)

Things I want to talk about at my next review
My question
Date:

What I found out
Date:

Things I want to talk about at my next review
My question
Date:

What I found out
Date:

What else do I want to know?

Are there other things that could help as well?
These could be things like:
Changing what I eat
Taking more exercise
Relaxing more

Other things that could help

Making Decisions

Making decisions can be difficult. We learn how to work out what is important to us. We learn to think about what choices we have. Here are two things that can help you make a choice about taking medication:
You could find out more about your medication
You could talk it over with someone, to help you make your mind up
Think about the people you want to ask to help you find out about your medication. It might be a doctor, a nurse or someone else you know.

Names of people who can help me find out more

What if I decide not to take my medication

What might happen if I didn’t take my medication?

Is there another medication I could take instead?

Is there another treatment I could use instead?

Make your mind up time!

You have found out lots of things about your medication. Now you need to decide which things are important to you.
Write down the important GOOD points and the important DIFFICULT points about taking your medication.
Look back at the things you wrote down earlier to help you. You might find it helpful to talk these things over with someone you know. This will help you make your mind up.

My Decision

This is my decision

This is why I made this choice

These are the people who helped me make this choice

Who do I need to tell about my decision?

Write down all the people you might want to tell

This workbook has been adapted (with kind permission) from booklets produced by the Medication Matters project. Medication Matters was a research project carried out by the Nora Fry Research Centre, University of Bristol. You can read more about this research at:
www.bris.ac.uk/Depts/NorahFry/medicationmatters
The research team talked to people with learning difficulties that were taking psychotropic medication, which is sometimes given to help people with their moods, their thoughts or behaviour.
They asked people what it was like taking psychotropic medication and what they knew and what they thought other people taking medicines should be told.
My Medication is a place for people to write a list of all the medications they take and what they need to know about their medication.
This adapted booklet is still in draft format and the Clinical Governance team are hoping that the clients and staff at Calderstones will help us by trying it out and letting us know if it is useful or needs changing in any way.
This draft booklet was produced in October 2005. We would like to know what you think of it and if we can make it any better.
If you have any comments please tell us:
Telephone: 2136, 2289, 2134
Linda Chadburn
Sian Bradley
Helen Duperouzel
Or write to us at the Clinical Governance Support Unit, Calderstones NHS Trust