• Too Many Pills On Your Plate?

    How to Simplify Your Medication Regimen

    IMAGE Donald, 74, leads an active life. He goes to the theater, does volunteer work, and plays golf. But when he sits down to breakfast he faces a plate full of pills. His wife, Judy, who at age 66 walks a mile twice a day, also stares down a pillbox first thing in the morning. Both dutifully swallow their medicines once, twice, sometimes up to three times a day. But they admit there are times when they forget.
    "It's very time consuming taking all these pills," says Donald. "I wish I had a pill in my pillbox that reminded me to take my pills."
    They are not alone. Millions of older adults take several medicines. Add vitamins, minerals, and other dietary supplements to the mix and you have got a schedule of pill swallowing that stretches throughout the day. For people with chronic medical conditions, keeping track of medicines can feel like a full-time job.

    Reviewing Your Schedule

    A study examined how doctors respond to seeing a chart of their patients' weekly medicine schedules. The chart listed the days of the week and then the time of day that each pill was taken. The doctors' responses were often striking. They would look at the charts and say "Holy Mackerel! This really is complicated!"
    After reviewing the charts, many of the doctors made changes that simplified their patients' medicine schedules. People should tell their doctors when their regimens become too complicated.

    Understanding the Reason for All of the Pills

    Most doctors know that taking many drugs multiple times a day creates problems. The more medicines you take, the harder it is to remember them, and the more likely it is that harmful medicine interactions will occur. Still, many older people end up taking a handful of drugs every day. Sometimes it is necessary; a lot of older adults with multiple medical problems need multiple medicines. However, patients can work with their doctors to try to simplify their regimens.
    Problems occur when there are several doctors involved who do not know what the others are prescribing, or when the patient and primary physician do not spend enough time reviewing the patient's medicines.

    Simplifying

    It often helps if you bring in your pills, or at least a list of your medicines each time you go to the doctor. Comparing your list to the list your doctor has is very important.
    Your doctor should work with you to simplify your medicine schedule. Ask if she can do the following:
    • Prescribe medicines that are taken only once or twice a day
    • Have you take combination pills which have two medicines in one tablet
    • Prescribe medicines that will not interact with each other

    Being Proactive

    There are things you can do to reduce the complexity of your medicine schedule. The experts offer the following tips:
    • Tell your doctor if you have problems remembering to take all your medicines. Creating your own medicine chart may help illustrate the complexity.
    • Use seven-day pillboxes to keep track of your doses.
    • Use one pharmacy for buying all of your medicine. This will enable the pharmacist to double-check for potential harmful interactions among all the medicines you take.
    • Understand what each pill does so that if your condition changes you can tell your doctor that you might need a change in your medicines.
    You can also be more proactive by being aware of any side effects that may occur due to medicines that you are taking. The information sheet that came with your prescription lists warnings, potential side effects, and contraindications (reasons why you should not take the medicine). Keep these information sheets handy. If you do have any side effects, let your doctor know. Your doctor may be able to adjust your medicines, or even eliminate some so the side effects go away. But, always make sure you talk to your doctor before stopping or adjusting your medicines.

    RESOURCES

    American Heart Association http://www.americanheart.org/

    Food and Drug Administration (FDA) http://www.fda.gov/

    CANADIAN RESOURCES

    Canadian Public Health http://www.phac-aspc.gc.ca/

    The College of Canadian Family Physicians http://www.cfpc.ca/

    References

    Cholesterol-lowering drugs. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4510. Accessed March 14, 2011.

    How to express your pain and how we manage it. University of Connecticut Health Center website. Available at: http://patientsafety.uchc.edu/patients/pain/pain.html#common. Accessed March 14, 2011.

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