Maintain Your Independence
Barbara is a 78-year-old woman living alone. Physically strong and independent, she takes great pride in tending her garden and keeping her home spotlessly clean. Like many older adults, she takes several medications for blood pressure, diabetes, and some vitamins recommended by her doctor. Though she sorts her pills into a box, she occasionally loses track of what day it is and forgets to take her pills. Sometimes she just skips doses because she feels better and doesn’t think she needs them anymore. Unfortunately, she has also had several episodes of skyrocketing blood pressure that have sent her to the emergency room.
“Study after study shows that taking blood pressure medications to keep blood pressure close to 120/80 reduces the risk of heart attack, stroke and heart failure,” says geriatrician Patricia Harris, MD, UCLA Medical Center. “Of course, if your health conditions have changed (weight loss, treatment for other conditions), it may be appropriate to stop a medication, but not without talking to your health-care professional and receiving appropriate follow-up.”
Not Following Doctor’s Orders
It’s estimated that as many as 50% of people don’t take medications as prescribed. Those who take multiple medications may find it challenging to follow prescribing guidelines. Do you take it with or without food? Morning or evening? The list goes on. And if a person has mild cognitive impairment, it’s easy to understand how challenging medication management can become. Pill sorters can only go so far.
Yet another complication could be the ability to afford prescriptions. Some people may simple forgo their medicines because they cannot pay for them or take less than prescribed to make the medication last longer. Fortunately, there are products and services that can help patients and their caregivers better manage it all.
Organize and Manage
Getting help with managing multiple medications is available in various forms. For example, it may be possible to obtain a combination pill to reduce the number of pills taken. Ask your physician or talk with your pharmacist about this possibility. Daily management techniques include sophisticated smart phone apps. MediSafe is an app that provides daily personalized reminders and also can send notifications to family members and caregivers to keep everyone informed. There are numerous pill dispensers, such as those available from Tabtime and MedELert, that prompt people to take medications by alerting them with lights, alarms, and/or vibrations. The units offer multiple options for organizing medications. Some require complex programming, which can be challenging for some people. But once it’s set up, it can make medication management much easier, especially for people with dementia, Parkinson’s disease, or conditions that require complicated medication regimens.
If you just want the daily pills sorted and/or easy-to-open containers, PillPack is a pharmacy-supplied service that delivers pre-sorted packets to your door. Each packet is stamped with medications, dosages, and when to take each one. Non-prescription pills, such as vitamins and supplements, can also be included.
UCLA MyMeds
Some medical centers, such as UCLA, have pharmacy programs that can help with many aspects of medication management. According to Dr. Harris, the integrated service has been extremely useful to her patients who take five or more medications. The pharmacologists work with patients to discuss the timing of medications, side effects, medication interactions, and the purpose for each one. Many people also have multiple doctors, and MyMeds monitors all prescriptions filled at the pharmacy.
“They provide excellent advice on how you can remember to take your medications, and which should be taken with food and which on an empty stomach,” explains Dr. Harris. “The MyMeds teams also let us know when we may have inadvertently prescribed two medications that shouldn’t be given at the same time.”
Another useful aspect of this kind of pharmacy service is their periodic review of all those pill bottles you may have lying around. Just toss them in a bag and take it your MyMeds team. They will go through them with you and tell you which to discard, or which may be the same medication with different names. If you need help with paying for meds, the MyMeds team will provide you with ideas and coupons for lower-cost medications, or work with your insurance plan’s formulary to find medications with lower copays.
Ask Questions, Discuss Options
Personal health status, knowledge about medications, and how they work in the human body change through time. So, just because you’ve been taking the same prescription for years does not necessarily mean you have to take it for the rest of your life.
“There is no doubt in my mind that medications for blood pressure and diabetes have allowed many people to live decades longer than they otherwise would have,” says Dr. Harris. “But, as a person ages, especially into the late 70s and beyond, some medications may no longer be needed. A good example is statin medications to prevent a first heart attack or stroke (not the second; if a person has had an event, that’s a completely different medical condition). In such instances, it may be time to ‘de-prescribe’, as we say in medicine.”
It’s possible you may be ready for a change. But do not stop any medications without consulting with your health professional first. Abruptly stopping some medications can cause dangerous side effects, such as a surge in symptoms the medication was prescribed to manage.
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