Cancel DC Renew Complete... What's the diff?

I am frequently asked how best to manage the Medication List. So often, we find meds that are duplicated, obsolete, or have simply run their course and no longer belong on the list. What's the best what to clean up the list? Well, there is no right and wrong for dc’ing meds. This is the way I like to think about it:

• Renew (think magazine subscription): The renew start date picks up at the last stop date
• Cancel/Reorder (think dose increase): the reorder start date is today and the canceled Rx is no longer in play, i.e. this is used for any dose/sig/pharmacy routing change
• Cancel/DC (think flushing the meds): this is the general way to dc any med, rendering it inactive and no longer visible on the active meds list
• Complete (think Z-pak): this is the way to dc a med that had a finite course, like an antibiotic.
• Maintenance v. Acute: maintenance will leave the med on the active list regardless of whether the stop date was reached. I find this useful, even in acute situations, to allow tracking at a follow-up visit. For example, I gave that Z-pak for acute otitis in March and the patient comes in today when I can ask about efficacy and tolerance. On the other hand, using the acute setting allows the med to complete and fall off the list of active meds. Many would argue that this is the proper and best way to manage the Medication List. We have left this up to the user.

Thanks to Rob Smith for the succinct question this morning!