A Comprehensive Guide To Medication Management

Elderly Medication Intake by the Numbers

The elderly population takes up a massive portion of prescription drug consumption. Despite making up less than 15 percent of the American population, the elderly use about one-third of all prescription and over-the-counter drugs. One study found that prescription drug use among seniors from 1988 to 2010 had “increased dramatically” over the period, and rates continue to rise into the 2010s.

Also, a large portion of this population takes more than one drug at a time, which is where the proper organization of medication management starts to become really important. In one survey conducted among over 3,000 people between the ages of 57 and 85, researchers found that:

• Over 80 percent of the participants used at least one prescription drug regularly.
• About 40 percent used at least one over-the-counter drug regularly.
• Nearly 30 percent of participants used five or more prescription drugs regularly. This percentage increased to the mid-30s percentage with men and women between 75 and 85.
• About half of prescription drugs users also used over-the-counter medications at the same time.

Effects of Managing Medication and Potential of Non-Adherence

Because of these large numbers of people who consume prescription drugs—especially by the elderly—there are many health and lifestyle effects from having to manage and then take the prescriptions. These effects can reveal themselves in social settings (or lack-thereof), in physical form, and in mental form.

None of the following health concerns can be mentioned without digging into the topic of non-adherence because of how it can directly cause the upcoming issues. Non-adherence is described as occurring “when a patient does not initiate or continue care that a provider has recommended.” When this happens, an elderly person can face a slew of health issues, which we’ll talk about soon.

It’s vital that patients adhere to the exact directions given to them, from the time of the day the medication is taken to how it’s taken. Non-adherence can happen deliberately (when the patient purposely stops the following medication) or unintentionally (when a patient is “careless or forgetful” of the medication prescribed, according to the FDA). One study of adherence of treatments following post-surgical eye health showed that those who stuck to the post-surgery treatment felt more comfortable in the long run than those who didn’t.

Falls

All medication has side effects. Whether they affect you or not is a different question, but you don’t know how they’ll affect you until you take them. Some side effects include dizziness, drowsiness, nausea, and other symptoms that can increase an elderly person’s chance of falling. Falls can then increase your risk of injury and even death. About 70 seniors die every day due to falls. Some of these falls can be caused by effects of prescription drugs, with one study revealing that up to 16 percent of hospitalizations among seniors were caused by “adverse drug reactions.”

Addiction

Massive prescription drug use among the elderly community results in an increased rate of addiction to these drugs. This, in turn, comes with an increased mortality rate. Addiction among seniors can sometimes go misdiagnosed because doctors assume the issues that can come with addiction (weight loss, altered sleep schedule, etc.) are a result of the drug itself and not abuse.

Depression

All of these issues are inter-connected. Millions of elderly people suffer from depression, which can be caused by the above reasons. Depression can be fueled by managing and taking medication, too, because it’s a side effect of some medications. It can also be caused by the side effects themselves (such as insomnia, which increases the risk of depression).

Isolation

A bunch of these issues and the corresponding health problems can be fueled by isolation, which occurs when an elderly person all but excludes themselves from interacting with family, friends, and the community. Medication management can force seniors into isolation because of how it causes addiction and depression. In turn, isolation can further advance the severity of depression and addiction. It also makes falling at home, when you’re all alone, that much more dangerous.

Medication management can clearly take a heavy toll on the elderly, so the process needs to be streamlined and made easier to help minimize the stress and health effects of doing it.

Medication Management Tips

Taking medication is part of the daily routine of many people 65 years old and older. This means it’s vital to make sure you know what medications you’re taking, when you need to take them, what they do to your body, when they need to be refilled, and a bevy of other concerns that take up a lot of time and energy.

As a result, the elderly especially need to make this process as simple and concise as possible, making sure family members, doctors, pharmacists, and themselves are all on the same page. Let’s dig into a range of tips that can help streamline this process.

Compile A List Of Medications And Make A Schedule

As we’ve learned, millions of elderly people take more than five prescriptions per day. There are also those who have 10 or more prescriptions they need to juggle at varying times. Just understanding what prescriptions one person is taking can be taxing, so to help clear this up, make a list of all the prescriptions you’re taking. Some items that can be included on this list are:

• The name of the medication
• What the medication treats
• The frequency that you need to take the medication
• How often the medication needs to be refilled
• The side effects of the medication

This list can easily be formed and updated on a spreadsheet processor on your computer, such as Microsoft Excel or Google Sheets.

You should also create a schedule for when these medications need to be taken. Old-school pill boxes that have the day of the week, different times of the day, and a little space to fill with the prescription are nice, but they can be a little taxing to keep up with. You may also have medications that don’t come in pill form, like sprays and topical ointments.

Instead, write out a schedule with all your prescriptions, when you need to take them, and how much of them you need to take. This makes it much easier to follow with the eye, especially if all of your prescriptions are organized in their containers in a single location.

This list is also good to keep handy when you’re going to appointments and visiting the pharmacist. Every doctor will ask you which prescriptions you’re already taking and for what reason, so it’s great to have all that information in one space.

Know What Medications You Can’t Take Or Combine

Over the course of your life, you may learn that you’re allergic to various prescriptions (like aspirins or antihistamines) or that they simply don’t work for you. You need to make sure you have this information available when talking to doctors and pharmacists.

There may also be prescriptions you can’t take because of your age or health conditions. While they shouldn’t be prescribed by a doctor or filled by a pharmacist in the first place, keep the dialogue open about the conditions or diseases you may have. Certain drugs can have adverse effects on you getting better, and they may combine poorly with other drugs you’re taking.

Be Cognizant Of How You’re Feeling

When you take more medications, you increase the chance of developing side effects from the medications because 1) simple probability, and 2) there’s more of a chance these drugs, once combined, can wreak havoc on your system. In order to help combat this, stay alert of how you’re feeling. Medication can impact your:

• Weight
• Sleep schedule
• Drive to be social
• Hunger
• Heart rate
• How your stomach processes food and drink
• How your organs work

Staying aware of how you’re feeling is vital so you can let doctors know what issues you may be facing when considering a new medication. Let them know as soon as possible, at least with a phone call, so they can advise if you should keep taking the medication and whether they should switch up what they’re prescribing.

Don’t Try To Prescribe Yourself

One of the worst things you can do when taking a lot of medications is adding more to the pile on your own. Just because you have a lot of prescriptions at your disposal doesn’t make you an expert.

Over-the-counter medications can seem enticing, especially for those with not-so-great insurance and high prescription costs. But OTC medications can react differently than their prescribed counterparts when you combine them with other prescriptions you’re getting filled. Adding something like aspirin or ibuprofen to an already-existing concoction of prescription drugs can potentially cause harm to your internal organs and your overall health.

If you feel the need to add any medications because of new problems or because certain drugs aren’t working, talk to your doctor or pharmacist. To that point…

Maintain One Pharmacist

You should try your best to limit yourself to one pharmacist. This way, they know the range of medications you’re taking and your medical information while understanding how all the drugs prescribed by varying doctors can affect you.

It’s important to have open communications and knowledge with the person filling the prescriptions. One study showed that having multiple pharmacies can increase a patient’s chance of “non-adherence,” meaning they’re more likely to not follow the directions of how and when they should be taking the prescriptions.

In some scenarios, this isn’t possible, because not all pharmacies carrying every single prescription drug known to man. Also, different medications may cost different prices at different pharmacies.

Ask Questions

Don’t be afraid to ask about the prescriptions you’re taking. This is your health and life we’re talking about here.

Any pharmacist or pharmacist technician should ask you if you have any questions for the pharmacist when they hand you the prescription. And if you have any questions, don’t be afraid to speak up.

Some concerns you may have include:

• How do I take this medication? (Not every prescription come in pill form)
• How often do I take this?
• What are the potential side effects?
• Should I take this with food?
• How does this react with the other prescriptions I’m taking?
• What happens if I miss a dose?
• Can I drink alcohol while on this?

You may have other situationally specific questions you have to ask the pharmacist, too. In any case, ask them.

Don’t Throw All Of Your Medications Into A Single Pile

Combining all your medications for the day into one pile may seem like a good idea, because it allows you to pop them all at once and be done with it. But you may need to take different prescriptions at different times of the day, and taking certain drugs in the morning could throw your body out of whack.

Organization is key when it comes to medication management. There’s no reason for all your medications to get jumbled together under one roof, which is exactly what the next section of this article is about.

Innovation in Medication Management

Medication management is far more advanced than it was in the middle of the 20th century, when many of the elderly people in America were born. Nearly every part of the process is so much easier, from simply being reminded to take the medication all the way down to when and how to take it.

“Smart” medication management devices, such as pill boxes and dispensers, can be set to open at certain times when certain medications are needed. You can also easily set alarms and then set alarms for those alarms to remind you to take your medication.

Some of these devices also have voice recognition software that can tell you about the medications you’re taking and listen to your commands. They can also be connected to your phone or computer. This is all in the name of making the process of taking your medication safer, quicker, and easier.

Let’s take a look at examples of some of these products and services:

PillPack

This service basically does all your management for you, because all you have to do is open the packages they send you and take the medication. It cuts out visits to the pharmacy and the process of sorting your medication. Just send your prescriptions with their instructions to PillPack, and they will sort them into small packages that have dates and times on them. The pill portion of your medications (aside from inhalers, ointments, and such) is dispensed by a small device you can keep in the bathroom, and the non-pill medications can be placed right alongside it. You also don’t have to worry about refills, because the company handles that too. This service can be a little expensive for some, but it pays off by streamlining the medication process.

Reminder Rosie

Reminder Rosie is aimed at those have memory loss issues like Alzheimer’s disease or other forms of dementia. To use the product, you simply speak into it, letting it know you need to set a reminder. You record the reminder in your voice, then tell the date and time you want the reminder to be played. An elderly person can record the message themselves, or a loved one can do it for them. For instance, you can record a message saying, “remember to take your blood pressure medication, mom!” and it will play the message at whatever date and time you set it for. The device also comes with a big digital clock, which can also help trigger remembering time-sensitive medication.

Pillo

This home-based system is a “smart” product that helps organize and dispense medications. It’s similar to Alexa or Siri in that there is a “companion robot” voice that can recognize the questions and concerns you have and responds to them. Pillo helps organize your medication, but it also can give you information on the medication and act as a social companion for the elderly. The product is available for $599 and is expected to be shipped out to homes by the fourth quarter of 2018.

Meda Cube

This device was made for those who have a “hard time remembering to take their medications,” according to the product’s site. Meda Cube can dispense up to 90-day supplies of 16 different medications (after you store them in various bins). Each bin is then assigned a time that it needs to be taken. When it’s time to take the medication, the device beeps and starts to dispense the pills. If you’re setting up the device for a family member, it will send you a text message or automated message if a dose is missed.

CYCO smart pillbox

Similar to other products on this list, Qualife’s CYCO pillbox aims to help the elderly with their medication adherence. “The CYCO integrates a dual sensor system with visual and audio aids, ensuring that the correct pills are consumed at the appropriate time by the user,” the company says.

If you have any other questions regarding medication management, from the medication itself to how you can better organize your medications, contact your doctor or other health professionals.