April 4, 2012

Your Advocacy Connection – Preventing Prescription Pitfalls

Toal,-DebBy Deb Toal
GolderCare Solutions

Remember when your medication regime consisted of taking your once-a-day vitamin? When did it get so complicated? Almost half of the adults in the United States, who are 65 or older, are taking at least three prescription medications. This does not factor in over-the-counter medication. Maybe your doctor has told you that you should take a baby aspirin, vitamin D, calcium and multi-vitamin and you end up with a fist full of pills that you may need to take several times throughout the day.

As a nurse, I’ve seen medication courses of treatment executed several ways. My mom would carefully read the medication instructions and diligently follow them. Sometimes it seemed mom was taking medication all day long! Following directions, she would take a pill 30 minutes before a meal and take another pill with food. Then she had an every six hours inhaler she would use last thing at night and set her alarm for her morning dose. She was a pharmacist’s poster child.

Many people don’t understand the urgency and importance of following their doctor’s orders and their prescribed treatment for medication. In some instances, not following directions can come with life-threatening results. When your doctor issues a new prescription or asks you to take a new over-the-counter medication, I would suggest you have your doctor clearly explain why the medications are needed and how long the medication will need to be taken. Ask your doctor to explain what the expected outcome from taking this medication will be for you. Some patients don’t feel “that bad” so they surmise that they don’t really need it or need the medication that much.

A concerned son (we’ll call him ‘Dave’) recently expressed his worries about his mom. His mom’s health had been fairly stable, but then over a few months, the family noticed a significant physical decline. She was less active and was having trouble breathing. She wasn’t feeling well enough to participate in the activities she enjoyed like her exercise class at the senior center and playing cards with her lady friends. One of the recommendations I made to this family was to do a “Brown Bag Survey” with mom’s doctor.

The “Brown Bag Survey” is a great tool for doctors and pharmacists to check the actual medications against their list of medications prescribed for you. It’s an easy process. Once a year, or more often if necessary, gather all of your prescription medications, over-the-counter drugs and herbal supplements you are currently taking and place in a bag and take the bag with you to the doctor’s office and your pharmacy. The doctor’s office and the pharmacy can assess what medication is actually being taken and how often. They can also check to determine if any of your prescriptions are inappropriate to take with certain over-the-counter drugs and herbal supplements.

As we age, many people have more than one doctor providing care and writing prescriptions for them. If Dr. Heart doesn’t know that Dr. Kidney changed your medicine, he does not have all the information he needs to provide you with the best care. From time to time, you will hear of Dr. X unknowingly prescribing a drug for a side effect of a medication ordered by Dr. Z. The patient forgot to update either doctor on his new prescription, and because he used two different
pharmacies to fill the prescriptions, the pharmacist didn’t catch it.

As it turned out, Dave’s mom was purposefully skipping doses of her medication to “save money.” The altered medication dosing was caught, because Dave took his mom’s medications and supplements to her doctor’s office, and the doctor’s staff found there were extra pills left in one bottle. Her physician re-educated her on why he had prescribed the medication two times per day and explained that the shortness of breath she felt was due to the missed doses. Once she understood that taking the medicine on the schedule her doctor had provided could prevent her from having to make a more expensive trip to the emergency room, she followed her doctor’s orders and took her mediation as prescribed.

In next month’s issue, we will be focusing on the Top 10 Tips for Safe Medication Use – an important topic no matter your age.

Deb Toal is a Care Coordinator at GolderCare Solutions Unlimited. She is an RN with Certifications in Geriatrics and in Dementia Assessment Care & Management. Deb loves the fact that at GolderCare the Solutions truly are Unlimited.