Medication errors at home and in the hospital are occurring at an alarming rate and are the leading cause of death and injury among patients. Communicate with your health care providers to ensure your medicines add to your health, not take away from it.
When we are sick, we turn to medications to make us healthy. Medications keep many chronic conditions such as diabetes, heart disease, and arthritis in check. They make pains go away, allergy symptoms disappear, viruses vanish, and feelings of depression and anxiety manageable. When used correctly, medications make our lives so much better. However, on the flip side, when medications aren’t used correctly, our health can take a major turn for the worse.
An adverse drug event occurs when a patient is harmed as a result of exposure to a medication. Some common adverse drug events especially among older people include falls, depression, confusion, hallucinations, and malnutrition. Adverse drug events account for nearly 700,000 emergency department visits and 10,000 hospitalizations each year, according to the Agency for Healthcare Research and Quality. Fifty-three percent of hospitalized patients there for medication-related injuries are over age 65.
Adverse drug events occur at an alarming rate and are a leading cause of death and injury among patients. The more medications a person takes, the more likely they are to fall victim to an adverse drug event, which is why seniors are especially at risk.
Fifty percent of seniors take an average of eight medications or more regularly, according to the National Council on Aging. Also, older adults are more likely to have memory impairments, as well as hearing and vision loss, which may compromise their ability to understand and remember medication instructions, especially when multiple medications are involved.
Medications play an integral role in maintaining a healthy lifestyle, however it’s important to know the dangers associated with your medicines, and what strategies you can take to ensure your medicines work for you, not against you.
Medicines come in various forms, including prescription and over-the-counter, as well as vitamins and herbal supplements. The older a person gets, the more likely they are to have multiple conditions that require multiple medications. The more medications a person takes, the more at risk they are for a medication error due to problems such as drug interactions and administration of improper dosages. It’s common for seniors to get confused by their medicines and forget which medicine they need to take and at what time of day.
In addition to taking prescribed medications, eight out of 10 adults self-medicate using over-the-counter medicines for various health conditions, most often for colds, coughs and seasonal allergies and often take more than the dosage requirements, reports The Center for Improving Medication Management & the National Council on Patient Information and Education.
Unfortunately, many people don’t consult their health care provider regarding the medicines they take (both prescription and over-the-counter) and may be overmedicating or mixing medicine inappropriately. In addition, herbal and vitamin supplements may interact with prescription medications and may not be appropriate to take with certain conditions.
It’s no wonder that more than 125,000 Americans die each year due to prescription medication non-adherence, twice the number killed in automobile accidents, according to the National Pharmaceutical Council and American Hospital Association.
Medicine-related complications have been attributed to these four issues*:
- Use of multiple medicines (also called polypharmacy)
- Drug interactions
- Human error (not filling the right prescription, unclear instructions, giving the wrong dose, forgetfulness)
- Poor medical management (incorrect medication prescribed, lack of communication and monitoring)
*The Center for Improving Medication Management & the National Council on Patient Information and Education
The best way to prevent errors is to become an active member of your health care team. That means taking part in every decision about your health care, including the medicines you take. Research shows that patients who are more involved with their care tend to get better results. Now let’s go over some strategies to keep you compliant with your medicines and out of the hospital.
Strategy # 1: Communicate
Communication is the key to making your medicines work for you. Be sure your health care providers know every single medicine you take including prescription, over-the-counter, vitamins and herbal supplements. If it makes it easy for you, either write down every medicine and dosage on a sheet of paper and bring with you to all of your health care appointments or do something called “brown bagging.” That’s when you put all of the medicines you take in a bag and bring with you to your appointments. Keeping your doctors up-to-date on everything you take will help ensure you get quality care.
To avoid being prescribed a medication that could harm you, be sure all of your health care providers know about any allergies or adverse reactions you have had to medicines. Never assume your doctor already knows this information.
Another communication tip: If your doctor writes out a prescription medication for you, be sure you can read it clearly. If you can’t read it clearly, your pharmacist may not be able to either. And lastly, ask about any side effects to the medicine you are being prescribed. If possible, ask the doctor to write down the side effects.
Strategy #2: Be Smart at the Pharmacy
Use one pharmacy for all of your prescription refills and do not hesitate to ask your pharmacist questions about the correct dose of your medicines, side effects, and to verify that you are getting the exact medicine your doctor prescribed. If the directions on your medicine labels aren’t clear, ask. Medicine labels can be hard to understand. For example, ask if “four times daily” means taking a dose every 6 hours around the clock or just during regular waking hours.
Another question to ask your pharmacist: What’s the best device to measure your liquid medicine? Ditch the household teaspoons, which often do not hold a true teaspoon of liquid, and instead use a marked syringe to help you measure the right dose.
Strategy #3: Ask These 5 Questions
You should ask for information about your medicines in a language you can understand, both when your medicines are prescribed and when you get them. These questions should help you get the information you need.
- What is the medicine for?
- How am I supposed to take it and for how long?
- What side effects are likely? What do I do if they occur?
- Is this medicine safe to take with other medicines or dietary supplements I am taking?
- What food, drink, or activities should I avoid while taking this medicine?
Strategy #4: Get Support
Ask a family member or friend to go to your appointments with you. Even if you do not need help now, you might need it later. Your companion can serve as a second set of eyes and ears for you and may catch something you missed.
Strategy #5: Use a Medication Organizer
A slotted pill box may help you remember when to take your medicines. It also helps you to know how much medication remains in your stock bottles and allows you time to refill prescriptions. Be careful when filling the organizer as mistakes can happen very easily.
A 2011 study by Northwestern University’s Feinberg School of Medicine found that 60 percent of caregivers made errors when sorting medications into pillboxes, which speaks to just how complicated sorting multiple drugs with various timings for delivery can be. Consider asking the pharmacist to sort the pills for you when prescriptions are filled. Some will do this routinely, while others will demonstrate it a few times to show you the best way to get started.
Strategy #6: Store Medications Properly
Many people routinely store medications in the bathroom medicine cabinet, but temperature changes and moisture levels can alter the medication once it is opened. Be sure to read the packaging on prescription medications for storage instructions.
Strategy #7: Get a Yearly “Medication Check Up”
Get a “Medication Check Up” at least once a year. Ask your health care providers to review all of your medicines, including supplements and herbal remedies, and determine whether all are needed, if there is the potential for drug interactions, or if dosage adjustments are needed.
It is especially important that older adults receive regular medication checkups since age-related changes can impact how a drug works in the body and often requires dosage adjustments and careful monitoring. Eleven percent of all hospital admissions and 23 percent of all nursing home admissions are due to failure to take medications accurately, according to the National Pharmaceutical Council and American Hospital Association.
Strategy #8: Take Your Medications as Directed
There are many reasons why people don’t follow a medication regimen prescribed by their doctor. For one, some may deny their illness and the need to take medications for it. Or they may not have faith in the effectiveness of their treatment, so they find alternative methods of fixing themselves or they give up altogether. Some people don’t like the side effects of being on medicine or are afraid of becoming drug-dependent, while others assume that once their symptoms improve they don’t need to take medicine anymore. Finally, for many seniors, financial reasons may cause them to not refill a prescription or skip doses to make the prescription last longer. This will only backfire as people who miss doses need 3 times as many doctor visits as others, reports the National Pharmaceutical Council and American Hospital Association. Contact your health care provider if you cannot afford your medicine. There is help.
Not taking your prescribed medicines or missing doses can worsen disease, impair functional ability, reduce quality of life, and possibly lead to premature death. However, if you feel a medicine is causing you more harm than good, contact your health care provider immediately. Often there are safer alternatives or a lower dose may be needed.
Understanding your medicines means you are taking a proactive approach to your health. Never hesitate to ask a question of your health care provider or pharmacist. They are here to help you. By using the medication management strategies we’ve discussed today, you are helping to ensure that your medications promote your health and safety, not take away from it.