Med­i­ca­tion Mis­man­age­ment

A lead­ing cause of poorer health and high health­care costs

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With nearly two- thirds of Amer­i­cans tak­ing med­i­ca­tion on a reg­u­lar ba­sis, and se­niors tak­ing an av­er­age of at least five pre­scrip­tions per day, med­i­ca­tion ther­apy has be­come quite a pill. “Re­gard­less of age, man­ag­ing med­i­ca­tion is one of the largest chal­lenges fac­ing health care to­day,” ex­plains Joan Car­roll, di­rec­tor of tran­si­tion of care at Lee Me­mo­rial Hos­pi­tal in Fort My­ers. “It not only af­fects the pa­tient’s health and qual­ity of life in­di­vid­u­ally, but also af­fects health­care costs for each and ev­ery one of us.”

That’s pretty hard to swal­low, con­sid­er­ing that a ma­jor­ity of the rea­sons it ex­ists are ac­tu­ally pre­ventable! Med­i­ca­tion er­rors are at the top of the list when it comes to avoid­able read­mis­sions to the hos­pi­tal. Lee Me­mo­rial Health Sys­tem has im­ple­mented pro­grams to pro­mote team­work among pa­tients, their doc­tors, and phar­ma­cists, to com­bat the chal­lenges of med­i­ca­tion man­age­ment and re­duce the costs of health care.

There are many ac­tions that you can take as well, and here’s what the doc­tor or­ders: COM­MU­NI­CATE. Talk with your doc­tor and find out as much as you can about ev­ery med­i­ca­tion. Ask ques­tions! “Many times, pa­tients al­ter their dosage or stop tak­ing a pre­scrip­tion al­to­gether be­cause they don’t un­der­stand how the med­i­ca­tion works or why they need it,” says Car­roll. “Some­times they be­gin to feel bet­ter and think they are cured, but what they don’t re­al­ize is that not fol­low­ing a med­i­ca­tion reg­i­men cor­rectly can have dire con­se­quences on their health.” READ. Be­fore you be­gin any med­i­ca­tion, read the la­bels and any ac­com­pa­ny­ing lit- er­a­ture. Make sure that the med­i­ca­tion treats your con­di­tion. Of­ten, the doc­tor may keep you on the same med­i­ca­tion but change the dose. Make sure that you have the med­i­ca­tion with the cor­rect dose be­fore tak­ing it. Find out the best time to take it and if you should eat first. Will it af­fect any other med­i­ca­tions that you are tak­ing, in­clud­ing over- the- counter med­i­ca­tions? What are the side ef­fects? “Be aware of ex­pi­ra­tion dates and prop­erly dis­pose of out­dated meds,” ad­vises Car­roll. “There is no guar­an­tee of ef­fec­tive­ness, or safety, af­ter a med­i­ca­tion has ex­pired.” CRE­ATE A SYS­TEM. For­get­ful­ness is the most com­mon rea­son for not fol­low­ing drug ther­apy cor­rectly. Or­der re­fills fif­teen days in ad­vance and set cell- phone re­minders to avoid miss­ing doses. Med­i­ca­tion boxes keep pills or­ga­nized and re­duce er­rors. Car­roll’s ad­vice: “Get [ a box] large enough to hold four daily times— morn­ing, noon, evening, and bed­time— while keep­ing a full week of doses. The best boxes will al­low you to re­move in­di­vid­ual days for travel or work pur­poses.” To serve as a re­minder, keep pill boxes in a place where you will def­i­nitely see them. Tak­ing meds at spe­cific times and in a spe­cific way will help to form a good habit and also re­duce for­get­ful­ness. MAKE A LIST. Keep a log of all your med­i­ca­tions and their dosage with you at all times. “Should an emer­gency sit­u­a­tion oc­cur,” says Car­roll, “this list will be a per­ti­nent source of in­for­ma­tion for re­spon­ders. It will also be use­ful at doc­tor vis­its to check for pos­si­ble drug in­ter­ac­tions.” TEAM­WORK. Peo­ple need to be ac­tive par­tic­i­pants in their health care as med­i­cal pro­fes­sion­als work to be in­no­va­tive and strive to im­prove meth­ods of treat­ment and com­mu­ni­ca­tion. Med­i­ca­tion rec­on­cil­i­a­tion and coun­sel­ing is one of the many ser­vices of­fered by Lee Me­mo­rial Health Sys­tem’s

Care Tran­si­tions pro­gram. “Nurses meet with pa­tients prior to dis­charge and once again af­ter they re­turn home,” Car­roll says of the pro­gram. “Dur­ing th­ese vis­its, they re­view any con­cerns, in­clud­ing med­i­ca­tion dis­crep­an­cies, and ed­u­cate pa­tients on self- care.”

Lee Me­mo­rial Health Sys­tem has also im­ple­mented a new records sys­tem called

Epic. It al­lows for seam­less data shar­ing among our health­care providers and Lee Phar­macy. “It’s a price­less tool that makes it eas­ier for us to work to­gether, and in turn, pro­vide safer care for pa­tients,” Car­roll says.

Med­i­ca­tion er­ror is the most com­mon safety is­sue in health care. A com­mit­ment to heal­ing is just as much the re­spon­si­bil­ity of the pa­tient as it is of the pro­fes­sion­als who are treat­ing them.

For more in­for­ma­tion about Lee Me­mo­rial Health Sys­tem, visit online at leememo­rial. org.

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