Pharmacology Update
The big day arrives: Your patient is home after 10 days in the hospital. Of course you are relieved, knowing she will be back at work in a few weeks. As you prepare to leave her home, she holds up a handful of prescription slips and asks, "What do I do with these?"
You might think, "For heaven's sake! Get the drugs and take as directed." Yet it is a valid question. Medication intake is generally safe in hospitals, where strict policies and procedures are established and followed. At home, however, drugs involve a real risk. You have probably witnessed it yourself: accidental overdoses, toxic interactions and more. Even commonly prescribed medications can have unexpected side effects. In an unsupervised and uninformed home environment, anything can happen.
The obvious safety solution is greater patient awareness and better information. But how? All of your patients are given a three-page handout with dozens of important instructions. By most estimates, less than 15 percent are ever read. Complicate that with statistics suggesting a large percentage of all medications are not taken as prescribed and many are not taken at all.
Detailed drug information has its place; however, with most patients, the simpler the better, especially in light of the other challenges a newly-released patient faces such as scheduling therapies and follow-up visits and returning home after being out with an injury. In reality, a volume of drug safety essentials can be reduced to just seven simple rules. In fact, many concerns can be alleviated by following this list of seven easy rules.
While they don't cover every eventuality, these common sense instructions can support a speedy recovery and help prevent a trip to the emergency room. Instructions should directly address the patients in language that is easy for them to understand. A simple handout such as the following presents the most important things for your patients to remember when managing their own medications.
Home Guide to Drug Safety
- Taking a new drug? Stop! Read the prescription label to verify exactly how and when it should be taken. If in doubt, ask your doctor or pharmacist. Every direction on a label has a reason. Even incidental directions such as "take with food" are there to avoid distressing reactions or improve the drug's effectiveness. Make sure you understand from your doctor the reason you are taking the medication and its desired effect.
- Let your doctor know all the drugs you are taking. Tell your doctor and pharmacist about all drugs you are taking. This includes over-the-counter (OTC) drugs and herbals. Your doctor must be aware of every drug you take, to be able to prevent harmful reactions. OTC products and herbals contain potent ingredients that can negatively impact or potentate the effect of your prescription drugs. Even an aspirin and Vitamin C can interact with drugs causing an undesired effect.
- Know what is in the prescription's product literature and keep it as handy reference. Today, most pharmacies provide these inserts with more detailed information about a medication, including potential harmful interactions and side effects. The product literature--not the label--lists important safety considerations. Most pharmacies now provide these inserts with more detailed information regarding a medication including potential harmful interactions and side effects.
- If you take several medications, make a written schedule for taking each one and check off each dose as it is taken. It is difficult to keep up with three or more medications. Without a system, it is easy to skip a dose, take a double dose, confuse drugs, or miss ordering a refill. If you do miss a dose, refer to the product literature. If you miss more than one dose, contact your pharmacist or doctor.
- Heed the special instructions for taking different dosage forms whether it is pills, tablets, capsules, liquids, inhalants, or ointments. The dosage form affects how the drug enters your system. For instance, chewing or crushing certain capsules can release too much at one time.
- If you feel "something is not right" with a drug, call your doctor or pharmacist immediately. "Not right" includes unexpected symptoms and pain. Drugs affect people differently. Your doctor can change the drug or dosage but only if he or she knows there is a problem.
- Remember to reorder the drugs you take continuously and at an appropriate time so you won't run out. Abrupt discontinuation of some medications can be harmful as well as inconvenient. Some medications require that a blood level be built and maintained. Interrupting these medications can make them ineffective; and you will have to see your doctor and start over again.
An additional safeguard for patients is to obtain all of their medications from the same pharmacy. Because the pharmacy maintains records of the medications a patient receives, the review of those records by the pharmacist provides another checkpoint for identifying potential issues with doses, interactions or other concerns of polypharmacy--multiple drugs and prescriptions. Pharmacists are excellent sources of information, willing to talk with patients about any of the concerns they may have.
Drugs should be stored in a safe, dry, moderate temperature location. Many people keep their medications in their bathroom where humidity levels can be high. Medications can deteriorate more quickly if they are stored under poor conditions.
Again, these simple rules do not cover every situation. Still, most patients and caregivers can deal with these seven items. By stressing these fundamentals, you will rest easier, knowing that you have reduced the hazard of any potential side effects and increased your patient's chances for a speedy and healthy recovery.
This article originally appeared in the November 2002 issue of HME Business.