Managing multiple medications

The average cancer patient in the U.S. is between ages 65 and 74. They will likely take several medications — for cancer treatment, pain, anti-nausea, sleep, anxiety and more — and may also be prescribed additional medications if they have other health conditions. This adds up to several prescriptions, dosages, sets of instructions and potential interactions to manage, which can be difficult for those who are older and unwell.

This challenge extends to those with a variety of illnesses, both mental and physical. A 2017 study found that patients who took 10 or more medications had a more than 90% likelihood of having one or more harmful drug interactions, with the highest prevalence among adults over 65.

According to Aravinda Thatte, a pharmacist with Sharp Rees-Stealy Medical Centers, your pharmacist is a vital resource and can help review your medications that have been prescribed to determine if there are any potential harmful interactions among them. Sharp Rees-Stealy’s coordinated care model is designed to help avoid adverse drug interactions, through a shared prescription information system and in-house pharmacies.

“By reviewing a patient’s medication list, a pharmacist may be able to identify some adverse reactions that the patient may experience, which could be confused for symptoms of illness,” she says. “Your pharmacist is a vital resource and can help review your prescription medications to determine if there are any potential harmful interactions among them.”

In addition, Thatte points out that it is not just prescription medications that should be reviewed. Over-the-counter (OTC) medications can also potentially cause adverse reactions when combined with prescriptions.

“Patients should clearly read labels on OTC products to look for any warnings against combining them with certain prescriptions,” Thatte says. “If in doubt, talk to your pharmacist to ensure it is safe to take a product along with a prescription medication, even if it is an herbal supplement.”

Your pharmacist can play a key role in helping you manage your medications or the medications of loved ones, Thatte says. “A pharmacist is your most accessible health care provider.”

She shares the following tips for working with your pharmacist to manage medications:

• It is important for all patients, especially seniors, to make and consistently update a list of all the medications they are currently taking and keep the list with them at all times. The list should include not just the names of the medications, but also the amount prescribed and the frequency with which they need to be taken. Your pharmacist is a great resource to consolidate all that information for you. 

• There are a variety of user-friendly pill organizers available and your pharmacist can help you choose what will work best for you. There are daily and weekly pill organizer boxes as well as electronic pill boxes with a timer that can be programmed to sound each time a dose is due. Newer, easy-to-use medication tracking systems are available that remind you when your medications are due, track when they are taken and can instantly notify your loved ones that you’ve taken a dose. 

• When picking up a prescription from the pharmacy, always get counseled by the pharmacist to receive the exact directions for taking a medication. This includes how much and when to take it, whether to take it with food or on an empty stomach, what side effects to expect, and how to store it. 

• It is important to fill all prescriptions at the same pharmacy so that your pharmacist can review your list of current medications for any possible drug interactions. Filling prescriptions at multiple pharmacies can lead to medications not being taken correctly and increased risk of drug interactions. Because there is often duplication in the ingredients of OTC products, your pharmacist can also help you choose appropriately, especially when you are self-prescribing OTC medications to treat minor, seasonal illnesses.

“Talk to your doctor and pharmacist about managing your prescriptions and OTC medications,” Thatte says. “If your condition is well-managed, periodic review of your prescription list during routine well-check visits should be sufficient. And always share your medication list with a trusted friend or family member, which is especially useful in case of emergency or while traveling.”

Sharp Rees-Stealy offers seven pharmacy locations across San Diego.