9 Quick Safety Tips to Manage Your Medications
By Johanna Trimble and Janet Currie
Track your meds. It’s up to you or your family to keep track of the drugs you are taking. Your medication list is unlikely to be available to all health professionals online! Electronic medical records systems often don’t “talk” to one another. Read more…
By Johanna Trimble and Janet Currie
Click here to download a printable version of this article
Always consult your doctor before stopping, changing or starting a drug.
1. Track your meds. It’s up to you or your family to keep track of the drugs you are taking. Your medication list is unlikely to be available to all health professionals online! Electronic medical records systems often don’t “talk” to one another.
2. Keep a list. For your safety, carry your own UPDATED list and keep one on your fridge. Make sure to include over-the-counter (OTC) drugs. Make sure drugs prescribed by specialists that you see are listed.
3. Stick to one pharmacy. Try to fill prescriptions from one pharmacy so drug interactions are easily checked. Any pharmacy’s list will only show what their pharmacy has dispensed to you and won’t include everything you take.
4. Don’t start a new drug when you’re alone. It’s rare, but if you have a severe allergic reaction you’ll need immediate help. Never take a prescription drug that was prescribed to someone else.
5. Check your prescription. When you pick up your prescription order, check both your name and the drug name on the bottle. At times, people who have the same name have received the other person’s drug.
6. Be aware of side effects and adverse effects. If you have a new symptom after taking a new drug, don’t assume it’s a “new condition” or “old age”. Tell your doctor or pharmacist right away. It could be adverse effects from the drug itself or an interaction with another drug you already take.
7. Beware of the prescription cascade. Sometimes new drugs might be prescribed to deal with symptoms caused by a drug you are already taking. This is called the “prescription cascade” – a common example is being prescribed a new drug for stomach upset, which may be caused by a drug you are already taking. Ask your doctor to consider whether new symptoms could be the result of the drugs and whether you should consider stopping a medication or reducing the dose, also known as deprescribing.
8. Look out for changes. Tell your doctor how new drugs affect you and whether there’s been a change for better or worse. Doctors may be depending on you to report and may not be actively monitoring the effects. If you SEE something (or feel something), SAY something (just like at the airport!). You do not have to be “right” in order to bring forward concerns about adverse reactions from a drug.
9. Seniors are more sensitive to medications. Older people are more sensitive to medications because of changes in their liver and kidney function as they age. In many cases, drugs for seniors should be prescribed at a reduced dose. The more medications used, the greater the chance of drug interactions. Drugs commonly prescribed to older adults can cause dizziness and loss of balance, leading to falls or factures and hospitalization, as well as cognitive and memory problems. Adverse drug reactions can start even if you have been taking a drug for a long time. Your doctor depends on you to raise issues of concern and to begin to talk about deprescribing some drugs: www.deprescribingnetwork.ca/starting-a-conversation
Read part 2 of this series here: 5 (More) Quick Safety Tips to Manage your Medications
Johanna Trimble is a patient safety advocate and member of the BC Patient Voices Network. She is a member of the Geriatrics and Palliative Care Subcommittee of the Council on Health Promotion for Doctors of BC. As an honourary lecturer, she co-teaches first-year medical students at UBC in Community Geriatrics as well as pharmacy students on medication issues in Long Term Care. Johanna is an active member of the Patient Awareness Committee of the Canadian Medication Appropriateness and Deprescribing Network.
Janet Currie is a social worker who has been involved with patient and medication safety issues for over 17 years. She is particularly concerned about the safety and efficacy of psychiatric drugs and their impacts on seniors. She is a member of the core Executive of the Canadian Deprescribing Network, the past co-chair of the Canadian Women’s Health Network and was a two-term member of Health Canada’s Expert Advisory Committee on the Vigilance of Health Products. She owns and manages a website on psychiatric drug safety and has frequently testified to the Canadian Senate and the Parliamentary Standing Committee on Health on prescription drug surveillance and adverse drug effects. She is completing a Ph.D. on medication safety and off-label prescribing at UBC. Janet is Chair of the Patient Awareness Committee of the Canadian Medication Appropriateness and Deprescribing Network.
5 (More) Quick Safety Tips To Manage Your Medications
By Johanna Trimble and Janet Currie
Ask for a medication review. Ask your doctor or pharmacist to review all your medications, especially if you are taking several or if different doctors prescribed them. Read more…
By Johanna Trimble and Janet Currie
Click here to download a printable version of this article
Deprescribing means reducing or stopping medications that may not be beneficial or may be causing harm. The goal of deprescribing is to maintain or improve quality of life. Always consult your doctor before stopping, changing or starting a drug.
1. Ask for a medication review. Ask your doctor or pharmacist to review all your medications, especially if you are taking several or if different doctors prescribed them. This means reviewing your complete medication list to make sure all are needed and not causing problems as you grow older. List drugs prescribed by specialists and over the counter drugs too. Often, doctors are able to give you an appointment that is longer than the usual 10 minutes to have a consultation about your medications. It is up to you to ask for a review of your medication: don’t assume that your drugs will be reviewed on an annual basis. Remember to ask your doctor if you can either stop taking some medications or lower the doses of others as a result of the medication review.
2. Medication issues in nursing home settings need to be addressed quickly. In a nursing home setting, get answers quickly if you have concerns about your medications or a family member’s. Patients can lose function and mobility if bedridden from a drug interaction. Delirium (a reversible state of disorientation, agitation or drowsiness) or unusual behaviour can be caused by medications and it may be mistaken for a serious chronic illness such as dementia. Alert your family members and be prepared to go, with your family, to management, if you have serious concerns or can’t get an answer. If you feel anxious bringing up medication issues, ask a family member to make an appointment with nursing home staff and have them accompany you.
3. Avoid anticholinergic drugs. Older adults are often prescribed anticholinergic medications (medicines that affect acetylcholine, a neurotransmitter) for common conditions such as overactive bladder, allergies, gastrointestinal problems, Parkinson’s and depression. Seniors are highly sensitive to the harmful effects of anticholinergic drugs. These drugs can have a negative impact on the brain by causing delirium, confusion and memory problems as well as physical effects such as dry mouth, constipation and blurred vision. Recent research is exploring whether these drugs have a role in dementia. While this link is still being explored, seniors should avoid these drugs whenever possible or ask for a safer alternative.
4. Ask questions and be wary. When your doctor suggests a new drug, you have the right to ask what the drug is for, what its benefits are and the risks of harm. Is the drug being prescribed for prevention? How likely is it that you would become ill in the future if you didn’t take it? Could the side effects outweigh any benefit the drug may have? It may not be worthwhile feeling unwell every day because of a drug to gain a small chance of having a little less risk of future illness.
5. Ask if deprescribing is appropriate for you. If a drug is bothering you, ask your doctor or pharmacist about the possibility of a “drug holiday” or a trial of stopping or tapering the drug and carefully monitoring the results. It is reasonable to see if a drug is causing problems if it is not a life-saving drug. You may find more information here.
See part one of this two part series: 9 Quick Safety Tips to Manage Your Medications
Johanna Trimble is a patient safety advocate and member of the BC Patient Voices Network. She is a member of the Geriatrics and Palliative Care Subcommittee of the Council on Health Promotion for Doctors of BC. As an honourary lecturer, she co-teaches first-year medical students at UBC in Community Geriatrics as well as pharmacy students on medication issues in Long Term Care. Johanna is an active member of the Patient Awareness Committee of the Canadian Medication Appropriateness and Deprescribing Network.
Janet Currie is a social worker who has been involved with patient and medication safety issues for over 17 years. She is particularly concerned about the safety and efficacy of psychiatric drugs and their impacts on seniors. She is a member of the core Executive of the Canadian Deprescribing Network, the past co-chair of the Canadian Women’s Health Network and was a two-term member of Health Canada’s Expert Advisory Committee on the Vigilance of Health Products. She owns and manages a website on psychiatric drug safety and has frequently testified to the Canadian Senate and the Parliamentary Standing Committee on Health on prescription drug surveillance and adverse drug effects. She is completing a Ph.D. on medication safety and off-label prescribing at UBC. Janet is Chair of the Patient Awareness Committee of the Canadian Medication Appropriateness and Deprescribing Network.