Medication management may mean many different things to different people, patients and health care professionals alike. I believe there are five core principles that will help a patient and their care givers master the technical side of medication management.
As I write these principles I draw upon my experience with my own parents. I am the youngest of eight children and sometimes I think that my parents help me get through pharmacy school so that they would have their own personal pharmacist available to help them manage their medications. Mom would let me know her tablets looked different from they looked last time, dad would be at the doctor’s office and would phone me to ask what his most recent prescription was, and I regularly helped them both organize their pill boxes.
I talk about this because we will all face this at some point. Regardless of whether we are the health professional, patient, care giver, child or parent, will need to understand a medication profile and help manage the administration process. Following are 5 core principles that will help navigate the medication management process.
#1 Develop a working relationship with a community pharmacist or hire a personal pharmacist: I realize that many people fill their prescriptions via a mail-order or big-store pharmacy. When you have a question about your medications, are you able to phone that mail-order pharmacy or request to speak to a pharmacist at the big-store pharmacy counter and discuss the topic with a pharmacist that you know and trust? If the answer is yes, fantastic. If the answer is no, then is the cost savings worth not having a community pharmacist available who knows your medication profile.
Community pharmacy is much more than just a place to fill your prescriptions. When a Community Pharmacy is responsible for filling your prescriptions, the pharmacist is available to you for questions whenever they are open for business. The pharmacist has your medication profile in front of them and can evaluate what you are currently taking and compare that with any type of medication or disease related question you may have. This is a great service and should always be considered as a first option if you are feeling a little out of sorts and wonder if one of your medications may be causing you to feel this way.
You can also hire a personal pharmacist who will counsel you about your medications and help your healthcare providers select the most cost effective medications for your conditions.
#2 Medication Reconciliation: This is a fancy phrase for having a complete list of your medications with you at all times. Write up a list that includes all of your current prescription medications, over the counter medications, dietary supplements, and medication allergies. Take this list with you to each visit you have with any health care provider and have them look at it. Make certain that the list that they have matches your list. This is a working list and will need to be updated or validated with each visit to your doctor or pharmacy.
This Medication Reconciliation process is especially important if you have had a recent visit to the hospital. Quite often medications change after a hospital and you need to be sure your list is complete and accurate before heading home from your visit.
#3 Take Charge: This is important and sometimes difficult to address. Everyone needs to do this; however, in my experience it is quite often overlooked. Pick someone, either a family member or a caregiver, and have a conversation with them about your medications. You are picking someone who will agree to handle your medication for you when you are no longer able to handle them yourself. This is a push to have you be an active participant in creating your plan, so that a plan is not created for you.
#4 Medication Storage: I encourage everyone to keep their medications in a safe, dry location such as your bedroom. It is important to not keep your medications in the bathroom because the moisture may begin to deteriorate the integrity of the tablet or capsule. More importantly, store your pain medications in a location that is not visible to visitors. As incredulous as this may sound, it is not uncommon for a visitor to come into someone’s home and take a few pain medication tablets out of their prescription bottle when the owner is not looking. Store your pain medications in your bedroom, out of visual sight from anyone who may be entering your room. Storage in a dresser drawer or your closet works well.
#5 Medication Disposal: How do I get rid of my medications when I don’t need them anymore? Please, it is a good idea to get rid of any old medications. Prescriptions that have been changed or eliminated do not need to be kept around the house just in case you might need them at a later date. It is more likely that there may be a medication mis-adventure if these are kept in the house.
Please, do not give your expired medications to anyone else to take, especially if it is a prescription medication. It is against federal law to share prescription medication. An individual needs to be evaluated by a healthcare practitioner and prescribed a medication before they may legally take a prescription medication.
Do not flush your medications down the toilet unless the medication should be flushed for safety reasons (for example, fentanyl patches). Check with your local pharmacy or your waste management program to see if there is a medication take-back program available.
If there is no medication take-back program available, then you may take the medications and put them in a container such as a zip lock bag. Mix in something unpalatable such as kitty litter or coffee grounds then add a little water to the mixture. Now, take the container and put it in a brown paper bag and put it in the garbage.
I realize that many people may have many more ideas of what medication management means to them; however, if you are able to master these five principles, you are well on your way.
About the author
Dr. Steve Leuck is currently a community pharmacist in a hospital out-patient pharmacy, where he educates and motivates patients to participate in their own pharmaceutical care. He is also owner of AudibleRxTM where OBRA 90 based Medication Specific Counseling SessionsTM are available in audio format.
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