HEART Insight:
doi: 10.1097/01.HEARTI.0000414788.07502.7f
Features: Medicine Chest

Good Medicine

Kurland, Sheryl

Free Access

Mike Smith has a heart condition and, like many cardiac patients, other health issues including diabetes, arthritis and a gastrointestinal disorder. He sees four doctors, his primary care doctor and three specialists, each of whom have prescribed medications as part of his treatment plan. Mike takes 12 prescribed drugs and three over-the-counter drugs at different times every day. Keeping up with his medication schedule is a daunting task, yet, doing so is vital to his health and well-being.

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“With more prescriptions being dispensed to patients, the number of medication errors is on the rise,” says Barbara Czerska, M.D., medical director of advanced heart failure, cardiac transplant and mechanical circulatory programs at Florida Hospital and associate professor of Medicine at the University of Central Florida in Orlando. Taking medications at the wrong time, forgetting to take a dose, taking too much of one drug or taking the wrong one could put your health in serious jeopardy.

A study by the World Health Organization found that half of all prescriptions written in developed countries, such as the United States, were not taken as prescribed. Of the 3 billion prescriptions written in the United States last year, 1.5 billion were either not filled or were used incorrectly.

“Teamwork between the doctors, nurses, pharmacists and patient is key to preventing medication mistakes,” says Czerska. “The patient needs to be an active member of his or her healthcare team.”

Whether you're like Mike and take many different medications or you take only a few, there are numerous ways you can help reduce errors.

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“Give every doctor and medical professional you see and every pharmacy you use a current chart of all medicines you're taking, both prescription and over-the-counter,” recommends Czerska. “In addition to providing every recipient a snapshot of your health, this list helps prevent your being given drugs that may interact with others and prescription duplicates.”

In the prescription section of your chart, for each drug, list the name and strength, reason for taking it, date started, dose, time you take it, prescribing doctor, doctor's phone number, next refill date, prescription expiration date and the name and phone number of the pharmacy where it was filled.

The over-the-counter section should include aspirin, antihistamines, vitamins, nutritional supplements, herbal products and other health-related remedies.

Another section should show your allergies to drugs, dyes, food and/or latex and the adverse reactions they cause.

Put your name and “today's” date at the top of the chart. Modify the chart and date any time your medications change. Keep a copy of the current version in your wallet and give one to a family member or close friend.

To help you get started, visit the American Heart Association's website at heart.org and search for “medicine chart” to get a free chart that you can download and print.

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In days gone by, the corner drugstore filled all prescriptions and one pharmacist oversaw a patient's medication regimen. Today, we have options—multiple neighborhood drug stores as well as ordering by phone, mail and online. “Having choices is a great convenience but it also puts more responsibility on the patient's shoulders to handle medication issues and make sure their medications are filled correctly,” says Dennis Pustinger, a pharmacy manager in Central Florida. “A patient shouldn't take a medication if he or she has uncertainties. Never be embarrassed to ask the pharmacist questions.” No matter which type of pharmacy you choose, these tips will help assure prescription accuracy:

* Although stated earlier, it bears repeating—provide a copy of your current medicine chart to every pharmacy you use.

* Make and keep a photocopy of your prescription before submitting it to your pharmacy. When you receive your medicine, cross-check the label for accuracy.

* Review the information sheet that comes with the medicine. Is the information consistent with what your doctor told you?

* If the medicine is a refill, does it look the same—in size and color—as what you have been taking? (Just because it's different doesn't mean it's wrong. Sometimes manufacturers change packaging, and sometimes pharmacies change drug providers.)

* Liquid medicine should only be dispensed with the measuring device that comes with it, usually a small cup, dropper or oral syringe. If one isn't supplied, ask your pharmacist. Don't use household spoons or a measuring device from another medicine.

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Now that you have the necessary information and right medicines, it's time to take them. These tips will simplify your at-home accountability:

* Create a “medication map,” a medication schedule that covers the whole day. It plots when to take what medicine, the dosage, and any special instructions. Check off each item after taking the medication.

* Use a medicine organizing container with “daily” or “weekly” sections. Or, color code your medicine bottles with different-colored stickers (for instance, yellow for morning, red for afternoon, blue for evening). You can also link taking medicines with activities, such as brushing your teeth.

* Keep medicines in their original containers until the day you are going to take them or put them in your organizer. Many drugs look alike, and this will prevent mix-ups.

* Never chew, crush, break or mix a tablet or capsule in fluid without advice from your doctor or pharmacist. Altering the drug can change its effectiveness.

* If you feel better or the medicine isn't helping, don't stop taking it without discussing it with your doctor.

* Order refills several days before you run out. Allow at least two weeks if your order is being delivered through the mail.

* Check your medicines every six months and dispose of ones past their expiration date or you no longer need to use. Contact your pharmacist or local Drug Enforcement Administration Office to locate a hazardous waste collection program. Or you can put medicines in a sealable bag, add coffee grounds or kitty litter (to make it less appealing to children and pets) and throw the sealed bag in your household trash.

* Never share your medicines with anyone. Never take medicines from anyone.

Keeping track of your medications can be a challenge, but these tips can help ensure that you're taking exactly the medicines you need when you need them so they work as prescribed.

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Listen to your doctor!

From filling out forms to talking about health problems to understanding your treatment plan, which often includes a new prescription, a doctor's appointment can cause information overload. Always bring a notepad and pen to take notes. If your doctor gives you a new prescription, clear instructions are essential to proper use. These are questions you should ask:

* What is the name of the medicine? Is this the brand name or generic drug?

* What is the purpose of the medicine?

* How much should I take?

* How often should I take it?

* What should I do if I miss a dose?

* How do I take it, for example, with food or on an empty stomach?

* What are common side effects and what should I do if they occur?

* What are the risks of taking this medicine or not taking it?

* When can I expect to notice improvement?

* How long do I need to take it?

* How should this medicine be stored?

* Does this medicine replace anything else I'm taking?

* Is it safe to take this drug with others I'm taking, both prescription and over-the-counter?

* Are there any foods, drinks and/or activities I should avoid?

* Will any tests be necessary while I'm taking this medicine?

* How often will I need to get the prescription refilled?

* What should I do when the prescription runs out?

© 2012 American Heart Association, Inc.