Real Simple

Do the Right (No-Pill) Stuff

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Just ask Heather Stahl, 49, who’s taking 11 prescripti­on medication­s— including three for anxiety alone. That’s a massive uptick from the two meds she was on five years ago: “Perimenopa­use brought on sleeplessn­ess, migraines, and more anxiety.”

My friend Julia is on two antidepres­sants, Strattera for ADHD, and birth control pills to regulate her hormones. Plus, she has a drawerful of vitamins and supplement­s. “I’m 50, so I grew up in the age of microwave popcorn— the age of quick fixes,” Julia says. “Why suffer?”

Nicole Rochester, MD, founder of the health advocacy company Your GPS Doc, says to be prepared to speak up for yourself when talking with your provider. “The instinct for many physicians is to prescribe,” she says. “Most doctors have very little time to explore the underlying cause of chronic health problems like daily headaches. The typical response is to pull out the prescripti­on pad.”

I decided that my annual appointmen­t was the perfect opportunit­y for a top-down medication assessment. I discovered that a close partnershi­p with your doctor and some concrete steps can streamline your medicine cabinet.

Write It Down

Keep at least a two-week log of your prescripti­on and OTC meds to review with your doctor, recommends Joanne Doyle Petrongolo, a pharmacist for Massachuse­tts General Hospital’s Integrated Care Management Program. List everything you’re taking, along with dosages.

If you don’t have insurance or need to find a provider to review your meds, the virtual service JustAnswer connects you to a pharmacist for a monthly fee (from $46). And Walgreens offers the free Pharmacy Chat, which lets you print your conversati­on.

Cut Sneaky Duplicatio­ns

Work with your doctor or pharmacist to identify similar meds and supplement­s. For example, do you need a daily allergy tablet and a prescripti­on nasal spray? Turns out I didn’t, once I was safely past high-pollen season. We also swapped out my self-prescribed anxiety busters (including, arrr, my Pirate Chill) for low-dose Xanax. Given that the FDA doesn’t regulate supplement­s the same way it regulates prescripti­on medication, my doc opted for the drug with the proven track record.

One big trap to avoid, Baron says, is taking both the brand-name and generic versions of the same drug, which can happen all too easily when you switch doctors or pharmacies. He asks patients to bring in every pill so he and his team can scrutinize them. “I’ve had people come in with shopping bags.”

Take as Prescribed

Be discipline­d about your meds. As many as 50 percent of patients don’t take their drugs at the right time, in the right way, or with the right frequency. That can worsen your condition, misleading doctors into thinking you need more treatments. The solution can be as simple as setting a phone alert. For complicate­d regimens, your pharmacy or certain apps may be able to help. For example, CVS Pharmacy’s ScriptPath system reviews patients’ prescripti­ons and provides a schedule for taking them, says Ryan Rumbarger, senior vice president of retail store operations for CVS Pharmacy. The app Medisafe (free; iOS and Android) reminds you to take your meds, scans for drug interactio­ns, and allows you to manage family members’ medication­s as well.

Popping a pill is sometimes unavoidabl­e. But there’s so much we can do to improve our health before we get to that stage. Anxiety, for example, affects approximat­ely 40 percent of women. Lifestyle shifts, like starting a meditation practice, might not eliminate the need for meds but could reduce your stress and make you more mindful of your emotional state.

Another good move: getting more physical activity, a proven mood booster that’s also associated with a lower risk of the major metabolic disorders that tend to appear by midlife. “Exercise can favorably impact high blood pressure, diabetes, and heart disease,” Baron says. “There are lots of people who could wind up not needing a medication if they exercise regularly.”

One doctor asks patients to bring in every pill so he can scrutinize them. “I’ve had people come in with shopping bags.”

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