Insights

As a nurse I know all too well the effects of medication mismanagement. People often begin taking medications as ordered when they are not feeling well but once they begin to feel better stop taking it altogether or become lackadaisical about it. People have told me they thought they didn’t need it anymore because they were feeling better. Other times people become frustrated with the amount of medications they are taking so they begin to stop medications they do not feel are necessary without consulting their doctor. Another reason why people may not take their medications as prescribed is because they cannot afford to purchase them but are too embarrassed to say so. Whatever the reason, the problem remains the same, medication mismanagement can have serious repercussions.

According to a study performed by Dr. Robert Harris of Cornell University, over 1.5 million adverse drug events occur each year and more than half of them are preventable. He also found more than 11% of the hospital admission for older adults were related to medication mismanagement, costing our health care system billions of dollars. These medication issues can lead to serious health complications including death. Conversely, when medications are managed appropriately, there can be a multitude of positive effects. Medications can help improve symptoms related to a chronic illness such as Congestive Heart Failure, depression, COPD (Chronic Obstructive Pulmonary Disease) or hypertension. They can also cure some diseases, for example when certain bacterial infections are treated with an antibiotic. They can improve quality of life and sometimes prolong it. Below is a list of things you can do to help improve how well you manage your medications.

Keep a list

• It is important to keep an up to date list in a place that is easy to access. Some people keep a copy on the refrigerator or near the door, others prefer to keep them in a wallet. Wherever you chose to keep it, be sure a loved one or your patient advocate is aware.
• Ensure all of your Health Care Providers are aware of all of the medications you are taking, including over the counter medications, vitamins and other supplements. This is especially important when you are seeing multiple specialists. We all need to be proactive. While most health care providers do work hard to ensure medication lists are accurate and up to date, we need our patients to inform us when changes are made.
• Bring a copy of your updated list to every health care appointment.

Ask questions and educate yourself

Always read the pharmacy medication pamphlet when starting a new medication. Also, when your doctor prescribes a new medication it is great to ask questions. Some things you may want to ask include:

• What is the intended action of the medication?
• What are the possible side effects of this medication?
• Are there any interactions with my current medications?

Have a system

There are many methods of medications management and every person should decide which method works best for them. The important thing is that you have a system that works for you. No one is perfect, a system helps keep you organized and the routine keeps you from forgetting to take your medications all together. Some examples:

• The most popular option is setting up your medications for the week in a medication box. If you are not able to do this yourself you can have family or a friend help or hire a private duty nurse to help.
• Numbering or labeling the bottles so they are easily identifiable and keeping your list handy for review daily.
• Keeping a chart that you can check off daily as you take your medications.
• Keeping your medication upside down in a box and then turning them right-side up as you take them throughout the day then turning them over again at the end of that day or beginning of the next day.
• Using a medication dispenser- this is a good option for people who want to continue to live independently but have a hard time remembering to take their medications. There are several variations of this product that can meet different needs.

Report allergies immediately

A true allergic reactions may include a rash, itching, trouble swallowing, difficulty breathing or swelling of the face, tongue or throat. Many people may experience upset stomach, nausea or other adverse reactions but there is a difference between an adverse reaction and a true allergy. Allergies must be report promptly and recorded to avoid future complications because allergies can be life threatening. Side effects should also be reported but are typically not as urgent to report as allergies.

Other Considerations

• Read the label
• Be aware of special instructions, such as taking a medications with food vs on an empty stomach
• Take only medications prescribed by you
• Be aware of storage recommendations
• If there is a language barrier ask your health care provider if they can provide written materials and instructions in your native language

Medication disposal

Medications should be removed from their original container and all personal information should be made illegible. You can place medication in something like an empty margarine container and mix in an undesirable substance such as kitty litter or used coffee grounds. Some pharmacies do take back programs, ask your local pharmacist. Some narcotics can be disposed of by taking to your local police department.

Who are your Health Care providers?

With so many people involved in your care it sometimes confusing to know who should be aware of your health information. There are many health care professionals that work together to make up the team of your health care providers including: Physicians (including all specialists), Nurses, Medical Assistants, Dentists, Physical Therapists, Occupational Therapists, Speech Therapists and Pharmacist. Each of those medical professionals listed are trained to be knowledgeable regarding medications and if we are not aware of a specific medication we know how to locate the most up to date information. The relationship between patients and health care providers continues to evolve and is becoming more of a partnership.

Resources

Porter Hills Home Care provides services and can answer questions regarding medication managment.

Links to assistance available for prescription drug coverage for people with financial concerns:

• www.socialsecurity.gov/extrahelp
• http://www.patientadvocate.org/resources.php?p=775%20%20
• https://www.rarediseases.org/rare-disease-information/resources-tools/financial-med-assistance
• www.needymeds.org/

http://www.hfwcny.org/Tools/BroadCaster/Upload/Project233/Docs/Medication_Management_Elders_Paper_3_15_11.pdf%20 – Robert D. Harris, R. Ph. BCPP. Enhancing Opportunities for Medication Management for Community Dwelling Elders: A Survey of the Current Landscape. February 2011.