This entry is part of an ongoing series where pharmacists describe inspiring patient interventions. Have a story you wish to share? Send it to vwood@ensembleiq.com.A patient with several health issues including diabetes, renal failure, heart failure and rheumatoid arthritis came to see me, and in the course of updating his changes to drug therapy (he always has a few when we meet) we discovered a potential problem. His nephrologist had stopped his ARB therapy, ostensibly because the protection it provides to the kidney was being obviated by its diminution of renal function.On his next visit the heart failure clinic started and ACE, also ostensibly for heart protection benefits of this medication. These drugs have bounced back and forth previously, and I discussed this with the patient and asked him who was changing what medications. He mentioned difficulty keeping track of who was doing what.I sent a recommendation to primary care as this (and potentially several other medications including antihypertensives and diuretics) may be adjusted by either specialty at any time, and it might be advisable to get all on the same page, and I offered to participate if wanted. It is not all that unusual to see patients caught between the different approaches and priorities of care focussed on specific health issues, and no one is better placed to note this and intervene than pharmacists as we see all of the medications and the changes that happen.