Since no medication can
ever be safe and effective UNLESS the patient takes it correctly,
it is critical that consumers be given the information they
need to carry out this responsibility wisely. We know that something
is wrong somewhere when all the research statistics report that
up to 50% of all prescription medicines are not being taken
correctly. This often leads to unnecessary medical complications
and health care costs shooting through the roof!
Many of these costs could
be avoided if we were more effective at teaching patients how
to take their medications correctly. And as the population ages,
more and more people will be requiring prescription medicines.
These unnecessary costs related to home medication errors are
only going to increase.
I was recently invited to
address the Drug Information Association and give my opinion
on whether consumers can understand the information they receive
about prescription medicines from magazines, the Internet, and
the patient information materials they are given from their
health care providers.
As I reviewed these materials,
I found that the ones meeting patient's needs for practical,
readable, and understandable information were few and far between.
Also, it is very difficult for consumers to identify prescription
medication information they can depend on.
One positive note is that
a small but growing number of pharmaceutical companies are developing
high quality, "patient-friendly" information called Patient
Package Inserts for some of their prescription medicines. Not
only are these Patient Package Inserts being written in language
consumers can understand, but the information is also approved
by the U.S. Food and Drug Administration. It's a good idea to
ask your doctor or pharmacist if there is a Patient Package
Insert for your medicine. It is certainly a source of information
you can trust.
Patients have to make decisions
about their medicines every day, but they can only make wise
decisions if they have the right kind of information. For instance,
they need to know what to do if a side effect occurs. Information
on side effects needs to be presented in terms that a patient
can recognize and understand. It's not enough to say that a
medicine can cause a serious liver disease such as hepatitis.
A patient needs to know how to recognize the warning symptoms.
For example, if they become unusually tired, lose their appetite,
have nausea or vomiting, develop a yellow color to the skin
or eyes, or have dark-colored urine or pale stools, they should
call their doctor.
When a person's health is
at stake, they will do all they can to protect it. Each person
decides if the benefits of the product are greater than the
risks they are personally willing to take. Once consumers and
patients receive information they can understand, they will
be in a better position to ask questions and determine how to
manage their medicines safely and wisely. Medicines will have
the chance to work, as they should. Health care costs will go
down. People will be healthier.
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Medicine
Tip: Patients taking chewable vitamin C tablets should brush
their teeth or rinse their mouth after each use. The ascorbic
acid in the tablets can stick to the teeth and over time erode
the enamel. One patient required 12 crowns after taking high
doses of chewable vitamin C.
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STAGGERING COST OF HOME
MEDICATION ERRORS:
THE OVERLOOKED COST IN PRESCRIPTION DRUG COVERAGE
Expanding prescription drug
coverage for senior citizens is on everybody's mind these days.
Everyone seems to be focused on the cost of buying the medicines.
However, nobody seems to be addressing the exorbitant costs
that result when patients do not know how to take their medicines
correctly.
The cost to purchase a prescription
medicine is minuscule when compared to the cost of treating
the complications that result when people do not know how to
take their medicine correctly.
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The estimated cost
to treat the complications resulting from home medication
errors totaled another $177 billion in extra medical treatments
provided by doctors, hospitals, and nursing homes. On top
of that, add in at least another $100 billion a year to
cover employer costs resulting from absenteeism and loss
of productivity from home medication errors. All together,
this amounts to at least $277 billion in costs from home
medication errors.
It doesn't make sense to
spend $111 billion to purchase prescription medicines, and then
spend an additional $177 billion in medical costs related to
medication errors and at least $100 billion in lost productivity
because patients were never given the information they needed
to manage their treatment correctly.
Research shows that when
patients are given the information they need to take a medication
safely, home medication errors are cut in half and people have
fewer side effects, fewer doctor visits, fewer hospital admissions
É and a higher quality of life. Not only do patients get more
benefit from their medicines, but health care costs go down!
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Medicine Tip: Patients
with asthma should not carry their inhalers in their pockets.
Some patients have required surgery because they inhaled coins
that had gotten stuck in the inhaler.
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20 STEPS CONSUMERS CAN
TAKE TO BE INFORMED ABOUT THEIR MEDICINES
Here are some practical
tips I suggested during my presentation at the conference on
"Safe Medical Treatments: Everyone Has A Role," sponsored by
the U.S. Food and Drug Administration and the National Patient
Safety Foundation:
1. Don't be afraid to ask
questions!! The only way a person can make informed decisions
and use medicines safely is to know what information is important
to obtain from health professionals, how to incorporate the
medicine into your daily lifestyle, how to manage side effects,
when to seek medical help and how to keep track of important
information for the doctor and pharmacist.
2. Ask your doctor WHY you
need the medicine being prescribed and how it is going to help
you. Discuss any concerns you have about taking the medicine
so that you have all the information you need to decide whether
you want to take it. If you do not want to take the medicine,
discuss this with your doctor so that a treatment more acceptable
to you can be prescribed.
3. Ask your doctor or pharmacist
if there is an FDA-approved Patient Package Insert (PPI) for
the medicine you are taking.
4. Since the average person
forgets 50% of what the doctor tells them by the time they arrive
at the pharmacy, ask the pharmacist to go over all the instructions
again.
5. If you would feel more
comfortable speaking with the pharmacist in a private area,
ask for it. More and more pharmacies have private counseling
areas to ensure confidentiality and better learning.
6. Ask the pharmacist to
show you the actual medicine so that you know which medicine
is used to treat which symptom(s).
7. Many people stop taking
a medicine because they think they are allergic to it. Actually
they may have had a minor side effect. Some allergic reactions
can be very serious and require immediate medical treatment.
If you have any questions about whether a symptom is an allergy
or a side effect, always ask your doctor and pharmacist.
8. Be sure you know how
to administer the medicine correctly. Some medicines, such as
inhalers to treat asthma, require complicated steps. Your doctor
and pharmacist can show you the steps to follow when using an
inhaler so that the medicine will reach your lungs and not get
sprayed on the back of your throat where it will not work. You
may want to ask the pharmacist to let you practice using the
inhaler in the pharmacy.
9. A prescription label
that states "Take 1 tablet 3 times a day" does not give you
enough information. Ask your doctor or pharmacist to help you
determine the best times to take the medication so you can easily
work the dosage schedule into your daily activities, meal times
and work. You will find it easier to remember to take your medicine
if it fits in with your normal lifestyle.
10. Try not to adjust your
medicine or skip doses without discussing this first with your
doctor or pharmacist. Some medicines can have very serious side
effects if they are stopped suddenly.
11. Many prescription medicines
can interact with each other as well as with over-the-counter
products and herbal remedies. Your doctor and pharmacist should
review all of your medicines at each visit and make sure that
you are not taking any prescription medicines that can interact.
It is important that you tell them if you are self-treating
with any over-the-counter product or herbal remedies. Even better,
ask them before you start self-treating!
12. If you receive written
instructions that just list side effects that could occur, ask
for more information. You need to know how to recognize the
early symptoms of common side effects and how to manage side
effects that may be annoying but are minor. You also need to
know when you should contact your doctor because of a side effect.
If you do not understand a medical term, do not be embarrassed
to ask what that term means. Keep asking until you understand
it!
13. If you think you are
having a side effect and don't know what to do, call your doctor
or pharmacist. You also need to tell them if you have done anything
to try to treat it -- such as skipping a dose, stopping the
medicine, or taking an over-the-counter or herbal remedy. This
information is important for them to include in both your medical
and pharmacy records.
14. Some people find it
helpful to keep a "medicine diary" they can take with them to
their next doctor and pharmacy visit. This diary can help you
remember important information to tell your doctor so the doctor
can decide if you really had a side effect or if the symptom
may have been caused by something else. Your diary can also
help remind you of important questions you want to ask.
15. Some medicines must
be stored away from heat, light or moisture in order to keep
their strength. Transdermal patches should not be thrown away
where children can find them and put them on like Band-Aids.
If you are traveling in a car during hot weather, don't store
your medicines in the glove compartment of the car. The heat
can destroy the medicine and it may not work.
16. Select your pharmacist
with the same care that you select your doctor. You want a pharmacist
who will take the time to counsel you at every visit and answer
your questions.
17. You should expect to
receive written information from the pharmacy that you can take
home. Keep this written information in a handy place where you
can find it if you need it. However, the written instructions
should NEVER take the place of personal counseling. You need
your questions answered so you can manage your medicines safely!
18. Find out how many days
in advance you should order your refills. Ask your pharmacist
to develop a program to help remind you to get your refills.
19. If you are having trouble
remembering to take your medicine, it is important to let your
doctor know this. Otherwise, your doctor may think that the
medicine is not working and may prescribe another medicine that
is less effective or has more side effects. All that really
may be needed is to work out a more convenient dosage schedule
for you.
20. Be sure at each pharmacy
visit to tell the pharmacist if you have had any problems with
any of your medicines. Your pharmacist can often provide helpful
advice.
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Medicine Tip: Do
you know which direction to pull the ear when administering
eardrops? For children younger than 3 years, pull the top of
the ear down and back. For children over 3 years and adults,
pull the ear up and back. This helps straighten the ear canal
so that the drops can reach the eardrum.
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Dr. Dorothy L. Smith is
an internationally recognized expert in patient education, patient
compliance, and behavior modification programs. She has devoted
her career to helping people make informed decisions about health
care and use of medications. Dr. Smith is the author of 23 books
and has appeared on radio and television programs across the
country to increase awareness of the important role consumers
play in their prescription drug therapy. In 1983, she founded
Consumer Health Information Corporation, a company internationally
recognized for its innovative patient information programs.
The organization has produced a broad range of print and audiovisual
programs that have helped millions of people learn to make wise
decisions about their health and medications.
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