Point-counterpoint: Should chronic disease medications be adjusted during unrelated hospitalizations?

Patients in the hospital frequently have multiple chronic conditions in addition to their acute illnesses. Inpatient providers may feel pressured to adjust outpatient medication regimens in response to acute variations in labs or vital signs during hospitalization, or in an attempt to optimize long-term disease control. However, this practice should generally be deferred to the outpatient setting, as the effective management of chronic conditions requires longitudinal care and should take place during periods of homeostasis. In select circumstances and for certain high-risk patients, stepwise modifications to chronic disease medications may be considered during hospitalization, but this should always be coordinated with the primary care provider.