By Allison Bond
NEW YORK (Reuters Health) - Miscommunication between healthcare providers and patient concerns over drug interactions lead to many seniors having an unnecessarily complicated medication regimen, a new study finds.
With a very complicated routine, “it’s easier to forget medications,” said the lead author, Dr. Lee Lindquist, a geriatrician at Northwestern University Feinberg School of Medicine in Chicago.
“If you consolidate the regimen, you can know that you’re done at the end of the day,” Lindquist told Reuters Health. For example, if a patient is prescribed three medicines that are each supposed to be taken twice per day, it’s likely they can be taken together each time.
For the study, published in the journal Patient Education and Counseling, nurses visited the homes of 200 patients over the age of 70.
All the participants had been discharged from the hospital one month prior and they averaged nearly 80 years old.
The nurses asked participants how and when they took their medications in a given day. Then a pharmacist and a doctor looked at each patient’s medication list to see the lowest number of times per day the participant could take his or her medications.
Next, they compared this number to the actual number of times per day that each patient had said they took their medicines.
Lindquist and her team found that 85 of the participants – just over 42 percent - were following a medicine regimen that could be simplified. Of these, 53 participants, or more than one quarter, could cut the number of times they took their medicines by once per day; and 32 participants, or 16 percent, could reduce that number by at least two times each day.
The team also identified the most common reasons for an overly complicated medication routine. One was patients’ concerns about interactions between food and medicines, and between different medicines. Another was misunderstanding medication instructions given to the participants by healthcare providers like pharmacists or physicians.
Patients should check with their doctor before changing the way they take their medicines, but the results of the study show the importance of a discussion between patients and providers about the logistics of taking necessary medicines, Lindquist said.
“That dialogue has to start; patients need to ask their pharmacist or physician whether they can cut down medications or consolidate them,” she said. The big questions patients should ask their doctors, she added, is “can I make it easier on me?”
One way that people taking many medications can work with a doctor on the simplest regimen is to walk through how they take medicines each day.
Dr. Serena Chao, a geriatrician at Boston Medical Center who was not involved in the study, said patients should bring all medicines to each appointment, and arrive "prepared to talk about what time they take their medications.”
“Go through all of the details, and then with the doctor, figure out whether the routine can be consolidated,” Chao told Reuters Health. Because after all, keeping track of lots of medicines can be difficult - but the goal is to minimize the inconvenience they pose to living everyday life.
“Your medications should not dictate your life. They should be working for you, not the other way around,” said Lindquist.
SOURCE: bit.ly/R5c6rd Patient Education and Counseling, online April 4, 2014.