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Keeping Secrets from Your Doctor and Pharmacist Can Harm Your Health

N. Beatriz Fuentes
Doctor of Pharmacy Candidate, May 2001
The University of Arizona, Tucson, AZ

Have you ever felt frustrated after you have visited with your doctor or pharmacist? Did you feel that your doctor wasn't clear describing the disease or drug regimen? Have you ever felt that your doctor didn't have enough time to listen to you? Did you ever arrive back home feeling frustrated that you couldn't remember what your doctor told you or it didn't make sense? Try to think back to the times when your doctor or pharmacist explained how to take your medicine and whether it might have helped if you would have asked more questions. Here is an example:

  • You get to the doctor's office. The doctor asks a few questions, and does a physical exam. The doctor explains the possible cause of your symptoms, may prescribe a medicine, and describes how to take it.
  • After the doctor's visit, you go to the pharmacy. The pharmacist asks if you have taken the medicine before. The pharmacist tells you how to take the medicine, potential side effects to look out for, and how to prevent or manage the side effects.
  • You get home and start taking the medicine. You get busy and forget to take your medicine - or even stop taking it. You might develop side effects and feel nauseated, drowsy, or light-headed, and you decide to stop taking the medicine.
  • Upon the next doctor visit, you are asked, "Have you been taking the drug?". Of course you say "Yes" because nobody wants to disappoint their doctor. Your doctor then asks, "Are you taking the medicine every day, three times a day, the way it was prescribed to you?" Once again, the answer is "Yes" to avoid feeling that you have let your doctor down. Actually, you are hurting yourself because now the doctor can't understand why you are not getting better. Your doctor might decide that the medicine you are taking is not working and may prescribe another medicine.
  • You go back to the pharmacy, are in a hurry, and tell the pharmacist that you know all about the medicine because the doctor has already told you how to take it. You get home, start the medicine, and for some reason you decide to stop taking it.

Study after study has shown that most patients are having problems taking their medicine correctly because they simply do not have enough information, misunderstand directions or forget what they have been told. It is normal for most people to forget much of the information after a few days. Unfortunately, this is not apparent to the doctor until one of your follow-up appointments. Unless patients are completely honest with their doctors, doctors will determine future treatment based on what you have told them. Lack of communication can have tragic consequences. Medication errors made by patients claim hundreds of thousands of lives every year simply because people do not take the prescribed medications properly or they skip them altogether.

The next time you receive a prescription from your doctor, make sure you clearly understand what your doctor and pharmacist are telling you. If you don't understand something, you need to ask questions. This is the only way to get the information you need to manage medicines at home and protect your health!

Don't be afraid to ask questions at every doctor visit. Be sure you know the answers to the following questions:

  • "What is the medicine for?"
    You need to know why the doctor prescribed the medicine for YOU.
  • "How will the medicine help me get better?"
    You want to be able to recognize the signs that the medicine is working and that you are getting better.
  • "How do I take the medicine?"
    If you don't know how to take your medicine, you could make a serious mistake that could cause dangerous problems. If your doctor tells you to take a medicine three times a day, be sure you know whether this means to take all three pills at the same time or one every eight hours.
  • "What do I do if I miss a dose?"
    This depends on actual medicine you are taking. It is always best to call your doctor or pharmacist and ask them what to do if you miss doses.
  • "What are the side effects of the medicine?"
    Your doctor or pharmacist should inform you of all the potential side effects of the medicines you are taking. It is important to recognize the differences between the side effects of a drug and the symptoms of your medical problem. If you are aware of them, you can help avoid many of the side effects.
  • "What can I do to avoid the side effects?"
    There are certain side effects that can be avoided if you take medicines correctly. For example, some medicines are best to take on an empty stomach because more of the drug gets absorbed into the body, but this may cause some people to get nauseated. Other medicines must always be taken with food.
  • "What can I do to manage the side effects?"
    Every medication can cause some side effects. But not every person who takes the drug will experience every side effect. You should be aware of the possible side effects before you start taking the medicine so you know how to manage them. For example, some people need medicine to lower their blood pressure. This medication could cause dizziness. When a person stands up too fast, they may get dizzy or lightheaded and could fall down and hurt themselves. To decrease the risk of falling, it may help to stand up slowly, and hold on to something that will help them keep their balance. Always ask your doctor or pharmacist how you can manage minor side effects from the medicine so you can keep taking it.
  • "Are there any drug-drug interactions?"
    There are medicines that should not be taken together because they can worsen your health. For example, Viagra should never be taken while also taking medicines that contain nitrates of any kind at any time. This includes nitroglycerin. A serious drug interaction could occur and even lead to sudden death. It is important to tell all your doctors and pharmacists of all the medicines you take. It could save your life!
  • "Are there any foods that I should not eat while I am on this medicine?"
    There are some medicines that should not be taken with certain foods. For example, some medicines that lower high cholesterol should not be taken with grapefruit juice. Other medicines interact with different foods.
  • "Will my medicine interact with any herbal products or nonprescription medicines?"
    There are some herbal products and non-prescription medicines that should be avoided while on certain medicines or if you have certain health conditions. For example, if you have uncontrolled high blood pressure and a stuffy nose, you should not buy decongestant products that contain pseudophedrine because it can make your blood pressure go too high.
  • "How should the medicine be stored?"
    If medicines are not stored correctly many lose their effectiveness. For example some medicines are very sensitive to heat and must be stored in a refrigerator. Other medicines can be stored at room temperature but must not be kept in placesthat have high heat or humidity. This is important for Arizona residents who are traveling by car in the summer. They should not store any medicines in the glove compartment of the car because heat can reach extreme temperatures and destroy the drugs. Always ask your doctor or pharmacist how long and where to store your medicines.
  • If you don't understand what your doctor or pharmacist is trying to tell you ask them to explain it to you.

It is always a good idea to keep a daily record so you can tell your doctor at your next visit when you started feeling better, any problems you had remembering to take each dose, minor side effects and how you managed them. The next time you go to the doctor, this record can help your doctor monitor your progress and provide better follow-up care.

Never leave your doctor's office or the pharmacy confused or uncertain. Also, be open and honest with your doctor and pharmacist. They don't expect anyone to be perfect. But in order to help you get better or manage your disease, they need to know what problems you are having and any concerns you may have about the treatment.

Your medicine can only be effective...if you know how to take it correctly!

References:

1. Just What the Doctor Ordered. Available at: http://www.thehealthpages.com

2. Jamer R. Following Doctor's Orders, Part 1. Arthritis News. 1991; 9(3).

3. Smith DL. Who Says Consumers Can't Make Decisions?. DTC TMES. 1999, 2(6): 19.

4. Jaret P. 10 Ways to Improve Patient Compliance. Hippocrates. 2001; 15(2).

5. English, Tom. Drug-related problems: Once a $76.6 billion headache, now a $177.4 billion migraine. Pharmacy Today. 2001; 7(3): 1, 10.

© 2001 Consumer Health Information Corporation. All rights reserved.