As people age, it’s common to take more prescriptions. From allergy medication to daily medications for blood pressure or cholesterol to supplements, it’s helpful to stay organized, but more importantly, it’s vital to stay safe.
According to a 2019 survey by the Kaiser Famly Foundation, more than half of adults older than 65 take at least four or more prescription medications.
Amy Sheller, the outpatient pharmacy manager at Riverview Health’s Noblesville hospital, answered questions for Current about some of the risks involved with a complicated medication routine and offered ways to stay safe.
Q: What is the best way for those with many prescriptions or supplements to organize their medication routine?
A: “At Riverview, we do offer what we call MTM – or medication therapy management – sessions. Those are one-on-one sessions with a pharmacist where anyone has the opportunity to bring in their medications, including over-the-counter herbal supplements they may be taking, and basically just have a pharmacist take a look at everything at one time.
“In today’s world, a lot of people are using multiple pharmacies and doctors, so that just adds to the complexity of their regimen. I think it’s important to be sure every doctor you see has an up-to-date medication list, but I think it’s nice to have a pharmacist look at it, too. So many times, we have patients who are going to Meijer for their free cholesterol meds or getting something through mail order and then getting everything else through us. We can’t really do our jobs to the best of our ability unless we’re able to see the whole picture.”
Q: What advice would you give to those taking many medications who do not have a family member, friend or caretaker helping them organize their medication regimen?
A: “If you don’t have someone helping, it’s important to have a pill organizer. They make ones today that have ‘breakfast, lunch, dinner, bedtime’ slots and so forth. You really want to get one that matches your routine and has the available slots that you need to match those medications. Pick a designated day each week to fill it. It also helps you plan further out and realize when you’re running low on a medication.
“Having an up-to-date, comprehensive list really helps, too. Many people create pocket cards so when they go to a doctor appointment or to the hospital for an urgent care or ER visit, they can just hand it to a nurse or doctor so they can get an idea of what their regular meds are. A chart or journal really helps for medications like insulin, so you can keep track of when you checked your blood sugar levels or when you took insulin and how much and at what time.”
Q: What are some of the most common mix-ups or errors you see when interacting with people in one-on-one consultations or at the pharmacy?
A: “The biggest issues come when changes are made to medications. So, for example, when a doctor increases your dose on a certain medication, you may still have some of the old medication at home. Maybe you didn’t bring the bottle with you to the appointment or back to the pharmacy, and you may take a double dose because you have two bottles. Or, for example, if your doctor switches you from one blood pressure medication to another, you might take your old medication with the new one.
“It’s just really important that when you get home, you completely remove the old medications from your pill organizer and dispose of it probably.”
Q: What is the best way to dispose of old medications?
A: “The Hamilton County Sheriff’s Dept. has a drop box in their lobby where people can leave their old medications. If people want to do that at home, we usually tell people to try to crush them up, mix them with water and put it in with old kitty litter or coffee grounds, or you can put it in an old laundry detergent container with a lid. You should not be flushing anything down the toilet.”
Q: What signs or “red flags” should caretakers, family and friends keep an eye out for when visiting loved ones who are taking many medications?
A: “If you look at a prescription bottle, you can see when it was filled and the frequency it should be taken. So, if you see that the prescription was filled in January, but it’s full, that may be a sign that the medication isn’t being taken as directed. On the flip side, if you see an empty bottle, but no newer bottle of the same prescription, it may be in need of a refill.
“Again, especially right after people go to the doctor or pharmacy, they may end up with multiple bottles of the same medication. There should just be one bottle per medication.”
Q: What are some other tips or tricks to stay on track?
A: “I would recommend getting all prescriptions filled at the same pharmacy if that’s an option. Also, you can always ask questions at the pharmacy during pickup to help get themselves familiar with what exactly the medication is for. It’s important to take ownership and know which medications are for blood pressure, cholesterol, allergies, etc., by even writing on the bottles what the medication is for. If you don’t know what the medication is for, you may not even need to be taking it anymore. But reach out to your pharmacist or doctor to clarify.
“In general, keep a list of everything you take, including information on how and when you should take it, what it’s for and maybe food tips like ‘take it with food,’ ‘avoid milk,’ ‘take on an empty stomach,’ etc. Also, it helps to store everything in the same safe place, ideally not in a bathroom or place with a lot of moisture.”