Medication management

Medication management care

Are you having trouble remembering to take your tablets? Are you on prescription medication and over the counter medication? How many medications do you have every day? Have you heard of a Home Medicines Review? Do you take five or more regular medicines? Do you take more than 12 doses of medicines per day? Do you have had significant changes to your medication in the last three months? Do you take medicines that require regular monitoring such as anticoagulants or insulin? Do you have difficulty managing your medication because of low vision or difficulty opening medication packaging? Have you recently been discharged from hospital or another type of temporary care? As a family member, do you have a loved one who is finding it difficult to manage their medication?

Medications play an expanding role in health care as we grow older. People are more likely to develop one or more chronic illnesses with advancing age, and appropriate medication can help seniors live longer and more active lives. However, medication use in older adults is also more likely to be associated with safety concerns. In this handout, learn how to get the benefits of medicine, whether prescription or non-prescription, while minimizing and managing the risks.

Seniors: their medicines and safety

Why is medication safety a particular concern for the elderly?

  • With a growing number of prescription medicines available and a growing population of older adults, the potential for medication safety problems is expanding.
  • As people age, they are much more likely to be prescribed more than one kind of prescription medication, and many seniors take three or more. This increases the risk for drug interactions, mix-ups, and the potential for side effects.

The effects of aging cause older adults’ bodies to process and respond to medicines differently than those of younger people. Age-related changes in the liver, kidneys, central nervous system, and heart are among the contributing factors causing elderly people to be more vulnerable to overdose and side effects.

  • Age-related challenges like memory loss or poor eyesight can make it harder to follow instructions for taking medication.
  • Financial issues may prevent seniors from filling some prescriptions.

High risks

It’s dangerous not to follow the directions for taking medications, but some factors can make that hard as people get older. Seniors should consider asking for help from their family, caregiver, doctor, or pharmacist if they:

  • Live alone.
  • Take 3 or more medications, including nonprescription medicine and herbal or dietary supplements.
  • Have memory problems or are not as sharp as they used to be.
  • Get prescriptions from more than one doctor.
  • Fill prescriptions at more than one pharmacy.
  • Use both online and community pharmacies.

Modern medicines have contributed to longer life spans, improved health and better quality of life. Medications are the most common treatment for many diseases and conditions seen in older people and persons with disabilities. Medicines now not only treat and cure diseases that were untreatable just a few years ago, they aid in the early diagnosis of disease; prevent life-threatening illnesses; relieve pain and suffering; and allow people with terminal illnesses to live more comfortably during their last days.

For older adults and people with disabilities, medications—prescription, over-the-counter, social drugs such as alcohol, and herbal remedies/alternative medicines—can be a double-edged sword. When not used appropriately, effectively and safely, medications can have devastating consequences.

As you grow older, you may find that you are using an increasing number of medicines including prescribed, over-the-counter and complementary medicines to assist in the treatment and prevention of diseases, increase life expectancy or improve quality of life.

Medicines may cause harm if used incorrectly or inappropriately and older people are more at risk of experiencing side effects from their medicines. You may also experience difficulties with vision, hearing, memory or cognitive functions that can make managing your medicines safely a lot harder.

So, it is important to understand as much as you can about the medicines you are taking. Ask your doctor or pharmacist if you have questions and tell them about any allergies or past problems you have had taking medicines. You should also make sure you tell them if you’re taking any medication that they may not know about.

Another good idea is to carry a list of your medicines with you. The list should include details such as the name of the medication, strength, what it is for, how much you take and when, and any special instructions. You can print out a list template or download a Medicines List App for your smartphone on the NPS (formally known as ‘National Prescribing Service’) website at www.nps.org.au.

Whether you’re living in your own home or in an aged care home, there are services that can help you to develop a plan for managing your medicines.

This can involve reviewing all the medicines you take to ensure you need them, checking your medicines are stored correctly and seeing if you will benefit from a dose administration aid or other system to remind you to take your medicines on the right day and at the right time.

Help at home

The Home Medicines Review (HMR) program may help you to manage your medicines if you’re living in your own home.

You may benefit from a medication review at home if you:

  • take five or more regular medicines
  • take more than 12 doses of medicines per day
  • have had significant changes to your medication in the last three months
  • take medicines that require regular monitoring such as anticoagulants or insulin
  • have difficulty managing your medication because of low vision or difficulty opening medication packaging
  • have recently been discharged from hospital or another type of temporary care.

The review by an accredited pharmacist takes place in your home, at a time convenient to you. The review gives you the opportunity to ask the pharmacist about your medicines and how to manage them well. Your doctor will use the results of your review to develop a medication management plan with you.

You can have an HMR once every 12 months, or more frequently if a significant change in your condition or medication occurs. You need a referral from a General Practitioner to have a HMR, so talk to your GP about this. Read more about the HMR program on the Department of Health website. Or, you can contact the Department of Human Services on 13 20 11 or talk to your doctor.

These days, it’s a common scenario for adults to be taking care of their ageing parents in addition to raising their own children. Members of this so called “sandwich generation” often describe a tug of war with competing caregiving demands—all the while holding down careers and households of their own.

When it comes to caring for elder parents, making sure they are following their medication schedule or even taking the reins to administer their medications will—at some point—become part of the drill. This is especially true for people whose parents:

  • Are older (75+ years old)
  • Have multiple medical problems
  • Experience declines in vision, grip strength or memory
  • Are no longer able to drive themselves to and from the pharmacy or doctor appointments

In these cases, playing an active role in managing your parents’ medications becomes even more necessary for their safety and health. Doing so will also help give you peace of mind.

Age-related changes also affect the way certain medications are absorbed by and work in the body. Help your older relatives get the most from their medications; make sure they are taking them the right way.

Here are 3 ideas to get you started

1. Know what your parent is taking. Keep a medicine record or list with the following information:
  • The name of each medication, including over-the-counter (OTC) medications (for example, aspirin or sleep aids) and dietary supplements (for example, St. John’s Wort, garlic, Vitamin D, multivitamins)
  • Why it is being taken
  • Who prescribed it
  • The amount (dose) taken
  • How often (for example, every eight hours, once a day)
  • Any special instructions (with or without food, by mouth)
  • Any problems or side effects that you might have noticed or heard your parent complain about
2. Be an active member of your parent’s healthcare team

Accompany your loved one to his/her medical appointments and make sure you have permission to call the doctor or nurse with questions and concerns.

At the next appointment, take the opportunity to review a current list of all of the medications your parent is taking. Find out if:

  • All of the medications are still necessary
  • Any should be discontinued because they might be unsafe or interact with other medications being used at the same time
  • The dosages are appropriate given your parent’s age and weight (depending on the medication, older adults might need a lower or higher dose than younger adults to get the same effect)
  • There is a simpler dosing schedule (many older adults have trouble juggling and remembering to take multiple medications at different times of the day)
  • There are ways to reduce costs (if cost is an issue).

A useful resource is the National Council of Patient Information and Education (NCPIE) that provides information on the safe and appropriate use of medicines. Follow their link for more information:  http://www.talkaboutrx.org/

3. Read the directions
  • It’s tempting to skip the fine print, but take the time to read the insert (written information) that comes with your parent’s prescription medications, as well as the Drug Facts label on the side of over-the-counter packaging. Ask your pharmacist if anything is unclear.

When picking up a prescription, double check the information on the prescription container.

Call Sequel today on 9499 1200 to find out how we can be of assistance.