"Reduce the Risk of Medication-Related Problems"

By Lisa M. Petsche

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People in the 65-plus agegroup are the biggest consumers of prescribed and over-the-counter medications. On average they take at least five prescription medications and two over-the-counter ones.
 
Every medication carries some risk, due to potential mismanagement (known as non-compliance), as well as possible side effects, allergic reactions or interactions with other drugs, alcohol or food. Add to this the fact that older adults are generally more sensitive to drugs—owing to slower metabolisms and organ functions--and the potential for problems is even greater.
 
When improperly used, medications meant to help with health problems can actually cause them. Quality of life is reduced, and hospitalization and even institutionalization can result. The cost to individuals, in terms of well-being and independence, and also to the health system, can be high.
 
Following are tips to guide you in effectively managing your relative’s medications.

Memory Aids

• Write out the daily medication schedule or ask the pharmacist for a chart to fill in. Keep it handy.
• Give medication at regularly scheduled times each day. Try coordinating it with regular activities, such as meal time (if they can be taken with food), a favorite television show or bedtime.
• When a new medication is prescribed, request the easiest possible dosing schedule. Post notes to yourself in prominent places, to help you remember the regimen until a routine is established.
• Consult the pharmacist regarding available aids and programs for organizing and remembering to take medications, such as logs, weekly pill boxes (known as dosettes), special blister packs and portable alarm systems.
  

Communicating with Health Professionals

• Accompany your relative on medical and pharmacy visits. Share his/her complete health history. Bring a notepad and pen to record information and instructions.
• Use one pharmacy for all medication needs.
• If you’re unsure about the instructions on a label, or have any concerns regarding side effects, consult the pharmacist.
• Inform the doctor or pharmacist if medication doesn’t seem to be effective, or if unexpected symptoms appear.
• Talk to the pharmacist before using any over-the-counter medication, such as pain relievers, laxatives or heartburn remedies.
• Maintain an up-to-date list of all medications—prescription and non-prescription drugs as well as vitamins and herbal medicines--your relative takes, including the dosage. Keep a photocopy with you. Give it to hospital staff if your relative has an emergency or planned admission. It’s also wise to keep a list of medications your relative can’t tolerate, and why.
• Inform the doctor and/or pharmacist if your relative smokes or drinks alcohol, as this may alter the effectiveness of certain medications. Also advise of any known or suspected food or drug allergies.
• Tell the doctor if your relative is seeing other health care providers, and advise the pharmacist of prescription medications obtained elsewhere.
• Ask the doctor or pharmacist to regularly review your relative’s medications.
• Post doctors’ and pharmacy telephone numbers by the phone.
  

Choosing a Pharmacy

When selecting a pharmacy, consider the following: hours of operation, dispensing fee, delivery service (preferably free), patient profiles, medication information sheets, and medication reminder programs (including cost).

Further Tips

• Before giving a new medication, thoroughly read the information sheet supplied by the pharmacist, as well as the medication label. If you have any questions, call the pharmacy to obtain clarification. Keep sheets together in a labeled file folder for easy reference. Carefully follow all instructions.
• If opening pill bottles is difficult, ask the pharmacist for easy-to-open caps.
• If you have visual problems, ask for large typing on labels, plus non-block letters. You might also want to request a duplicate, large-print label on a flat surface, such as a medication information sheet or a blank piece of paper. Ensure bright light and use a magnifying glass to check labels before giving out medication.
• Ask the pharmacist's advice before crushing or splitting tablets.
• Don’t cut short a course of treatment without consulting the doctor.
• Never share or borrow medicine.
• Storage tips: Keep medicine in its original container, away from heat, light and moisture (don’t store it in the bathroom), and out of the sight and reach of grandchildren, as well as your relative if he/she has memory problems. Store yours and your relative’s medications separately.
• Never use medicine that’s discolored or has an unusual smell; return it to the pharmacy. Also return any expired or no longer needed substances, to avoid inadvertently using them, and for proper disposal.

Final Thoughts

For every medication your relative takes, be sure you know the following: brand name and generic name, plus dosage; what condition it’s for; what it’s supposed to do and how soon you can expect results; where to store it; when and how it should be taken, and for how long; any substances (alcohol or certain foods or over-the-counter medications) or activities to avoid while it's in use; possible side effects and what to do if they occur; what to do if a dose gets missed or you run out of medication; and who to contact if you have a question or run into problems.
 
Knowledge is power, and will help you significantly reduce your relative’s risk of medication-related problems.

Lisa M. Petsche is a medical social worker and a freelance writer specializing in health and elder care issues.