Medication Management – YIKES

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Like me, I’m sure you laugh at the ads on television.  The ones that promote this or that new “miracle” drug that’s guaranteed to help your condition, whatever it is, and have a few minor side effects like respiratory failure, suicidal thoughts or actions, or cancer.  It’s amusing in a way… but some of these medications have been helpful.  The notion is that you take this medication to improve your quality of life, yet the irony of these potentially lethal side effects gets one’s attention.

The new meds we are encouraged to “ask your Doctor about ” aren’t the only dangerous ones on the market.  Many of our aging loved ones are on medications for high blood pressure, anticoagulation, memory, cardiac issues, pain, etc.  As is the case sometimes, an elder with many physicians has prescriptions being written from various sources.

Do you find (I do) that going into a new appointment, you read your medication list, and half of them have been discontinued?  I’ve often heard from frustrated patients and their families that “the right hand doesn’t know what the left hand is doing.”  The best person to take ownership of your medical history and medications is…YOU (or a trusted loved one in your place).

 

To get you started, here are four tried and true essentials for accurate medication management:

  1. 1.      Have an accurate, updated medication list. This simple tool could be critically important if you find yourself with a new provider, at urgent care, or on your way to the Emergency Room.  A master list encompassing all providers and pharmacies is crucial.  All members of your team should have a copy of this list.
  2. 2.      Use a medication box and designate someone you trust to pre-fill it accurately each week.
  3. 3.      Auto-refill. Check the refills of your medications and either initiate auto-refill or cancel it. Periodically check for accuracy as doses and meds may frequently change.
  4. 4.      Dispose of unused or expired meds. Clean out the medication cabinet and gather what needs to be discarded.  Look for expired prescription medication, narcotic meds from past injuries or surgeries, and over-the-counter meds (like ibuprofen and acetaminophen).

The line between accuracy and error is fine.

While medication errors in hospitals and other care facilities are hot in the news, mistakes happen at home even more frequently.  In many instances, one particular medication dose may be changed on paper but never implemented in reality.

Let’s consider Sally’s recent experience: Auntie Sally is on a blood pressure medication she has taken for 20 years.  Her blood pressure is creeping up, so her health care provider orders an increased dose.  Sally gets the medication but never takes it and keeps using her old one.  Her pressure goes up more, and despite her insistence that she has been taking the new dose (she has not), her provider orders an even larger dose.  Someone in the family notices that she is taking the original dose, makes the change, and guess what?  Aunt Sally’s blood pressure takes a considerable dive, leaving her light-headed and at much greater risk of falling.

This is an all too familiar story to those of us in health care, particularly those in home care.  The right medication, the right dose, taken at the right time, and in the right way can be lifesaving and life-changing.  If any one of those four “rights” is not… the outcome can be problematic.

You’ve gone through your medicine cabinet. Now, what do you do with it all?

In 40 years of practice, I've seen medicine cabinets full of expired drugs, meds that haven’t been taken in years, or meds of those who don’t live in the house anymore or who have passed.  Keeping these medications around is unsafe in countless ways.

It is no longer appropriate to dispose of meds down the sink, toilet, or trash.  Medicine “take-back” options are the best way to safely dispose of unused or expired prescription and nonprescription meds.  Most local police stations, pharmacies, and hospitals have medication disposal receptacles.

Periodically, the DEA (U.S. Drug Enforcement Agency) hosts “National Drug Take-Back Day,” during which temporary drug collection sites are set up in communities nationwide.  The next Take-Back Day is April 30, 2022. Visit TakeBackDay.dea.gov to find a collection site near you.

When taken correctly, medications are a powerful contributor to our wellness.

Mismanaged, they are conversely detrimental.  Getting your arms around this issue will be a layer of protection for the vulnerable members of your family.

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