Are Pills A Problem? A Powerhouse Patient Pops Some Questions By Julie Buyon

By agebuzz Contributing Editor Julie Buyon

My mother used to refer to someone (including me, sometimes) who was problematic or annoying as “a pill.”  Well, for many of us, our prescriptions are “a pill.”

According to a report by the Centers for Disease Control and Prevention, 83% of U.S. adults in their 60s and 70s had used at least one prescription drug in the previous 30 days and about one-third used five or more prescription drugs. Whether you are juggling multiple medications long-term or are taking 2 drugs on a 10-day course of treatment, you’re not the only one finding it challenging to stay on track with your pills. Public Health researchers tell us that medication nonadherence (medical jargon for not taking your medications as directed) costs us our good health and costs Medicare BILLIONS in avoidable emergency room visits and hospital stays. 

A Powerhouse Patient should consider these questions about his or her medications:

What pills am I popping?

Why am I taking this?

How can I stay on track and on time with my medications?

What Pills Am I Popping?

If you aren’t already keeping a list of your medications in your health notebook, try this Medication worksheet from the National Institute on Aging to list all your current medications as well as any vitamins, supplements, over-the-counter (OTC), and recreational drugs you take.  Bring it with you to every doctor appointment and review it with each of your doctors.  

Many of us, especially older adults, are taking an awful lot of prescription medications. The medical term for it is polypharmacy (jargon for many drugs), and it is a hot topic in the medical community. In response, many clinicians are advocating “deprescribing” with the goal of eliminating unnecessary or inappropriate medications that may do more harm than good. 

Why Am I Taking This?

Make sure you understand why you are taking everything on your medication list and discuss with your doctor to determine if everything on the list is really necessary and in line with your goals for your care.  

Remember, your physician is your partner in your care and won’t know if you are having any issues with your medications if you don’t speak up. People don’t take their prescribed medications for many reasons, including:

• Fear of side effects they have experienced or they have heard about. Never hesitate to discuss any side effects you are having with your doctor. There may be a different medication to try or advice on how to manage the side effects. 
• Cost is an issue for many people, so don’t fill the prescription until you’ve asked about how much of the cost will be covered by insurance. Often there are less expensive alternatives that can be prescribed. Your physician can help you find ways to cover the costs of your medications if they are too expensive for you. Check out the many resources that can help defray medication costs in my How a Powerhouse Patient $ave$ Money post.
• Pill fatigue is a real thing. Downing numerous pills throughout the day can cause people to avoid taking them. Once you and your physician have agreed upon the necessity of the medication, ask if there is a longer-acting version of the drug available so you can take it less frequently. Combination pills, aka “polypills”, combine multiple medications for a condition into a single pill. A recent study found that heart patients taking a polypill had significantly fewer cardiovascular events, including one-third fewer cardiovascular deaths. 
• The pill is difficult to swallow. Let your doctor know so an appropriate substitute can be prescribed.  
• Don’t assume that just because you don’t have any illness symptoms that it’s safe to stop taking the medication. Many medications (such as antibiotics) aren’t effective without the full course of treatment or are needed to manage a chronic condition. Don’t stop any medication without consulting with your physician because doing so may be harmful to you.
• We all just forget…and no, it doesn’t mean your memory is failing! Here are some tips for remembering to take your meds!

How Can I Stay On Track And On Time With My Medications?

The number of medications you take and how long you need to be on the medication will influence which methods might work best for you.

• Make the medication part of an existing and well-established routine. For example, I take a pill every night immediately after I brush my teeth and I take my daily calcium supplement with my breakfast. This helps me be sure to never miss a dose.
• Pill organizers, available for a few dollars at any drug store or online, come in multiple shapes and sizes – from single to multi-dose 7-day organizers. These are a great aid for remembering when to take your pill and eliminate second-guessing regarding whether or not you did take the medication. Your pharmacist can help you organize your medications.
• Many pharmacies offer “blister-pack” services, in which they presort your medications into single-use plastic packages noting what time of day you should take the contents. Check if your local pharmacy offers this option.
• If you are on multiple medications, you can consider a monthly prescription subscription service such as pillpack or CVS SimpleDose which sends you a month’s supply of all your medications (as well as vitamins, supplements, and OTC medications) presorted into labeled blister packs. Such a service can make sure you never run out of your medication, check for any harmful interactions among your medications, eliminate multiple trips to the pharmacy in addition to having your morning, midday, and evening pills sorted and labeled. And you don’t pay anything extra for the service – just your usual copay for each medication. Here’s a good comparison of 7 national subscription services. Before you sign on to a subscription service, discuss if this is an appropriate option for you with your pharmacist or physician.
• Automated medication dispensers are also an option, albeit an expensive one, costing from hundreds to over a thousand dollars and not covered by Medicare. As Tech Enhanced Life explains “They are all designed to make available the pills you need when you need them, without you needing to do much thinking, and to prevent you from taking the wrong pills at the wrong time.” Read their comparison of available machines here. 
• There’s an app for that – Medisafe is a free and easy-to-use medication reminder app that can also alert you to harmful drug interactions. I found it really useful when I had to take two different medications for a week – one medication was taken 4 times a day and the other 3 times a day. The app spaced out my doses, buzzed me a reminder when I was due for a dose, and didn’t stop nudging me until I clicked on the app to indicate I had taken the dose. I think it’s a great option for both short-term and long-term medication management.

Remember, your doctor is the medical expert and you are the “you” expert.  Take the lead on reviewing your medications with your healthcare team (of which you are the captain!) and speak up about any side effects, fears, or obstacles you have in taking your medications. Never hesitate to ask about modifications to your medication regimen.  Understand why your doctor believes the benefits of the medication outweigh the risks and/or burdens it may present.  Your doctor won’t know about the burdens unless you share them!  Don’t worry about “being a pill,” just be a powerhouse partner in your care!

Julie Buyon is a palliative care patient advocate. She has professional and personal expertise in assisting people with complex illnesses navigate the health care environment. Julie’s role is to help patients feel empowered, and her agebuzz posts are intended to make sure agebuzz readers have all the tools and info they need to advocate for themselves and their loved ones. Julie would love agebuzz readers to email her at [email protected] with any questions or problems encountered with the health care system, and she will do all she can to address those issues in upcoming blog posts. She also welcomes feedback regarding her advice or recommendations. Read all of Julie’s agebuzz posts here and get in touch with Julie now at [email protected].