By Lynn Harrelson, Pharm. B.S., FASCP
Medication use in today’s patient is not as simple as it was in decades ago……but could it ever be simple again? Was it EVER that simple????
Medications used in the mid-century were thought to be more simple medications that closely related to natural products, changed slightly allowing a compound to be patented; some medications were widely used by patients without robust study protocols.
The research process for medications coming to market has been in place for a while but after the World War II, renewed research in possible cures was and continues to be explosive. During these past years we have seen many changes in research that drives and demands that the consumer use medications in better ways.
Research today includes better balances of males and females, and younger and older patients. This part of today’s research helps us establish better dosing guidelines and determine optimal doses for the different patients. It not a simple splitting of the dose…..”If your child is half the size of an adult, give them half the dose”. We have learned that the dose of some medications needs to be changed due to how the body is working.
The names of medications are now included on your prescription labels. Just 20 or so years ago, pharmacists could not provide the name of the medication on the label. And, if patients had questions about the purpose or contents of the prescription, they were directed “talk to your doctor”.
Patients stayed with the same doctor most of their lives, they were seen by the same doctor in their office and during their visits to the hospital and nursing home.
So how have things changed?
- In today’s healthcare world, medications are highly modified to improve/increase outcomes or results.
- Research studies are more highly controlled and monitored.
- Very specific study protocol are developed, women are randomly included except for male specific studies.
- Dosing guidelines for individual medications are developed for children as well as those who have reduced kidney or liver function.
- Medication names, generic names, specific use, cautionary labels are on prescription containers and we receive medication guides full of information that is approved by the FDA and deemed to improve patient safety.
- But today, our health care is provided by a multitude of providers. It seem everyone specializes in a specific practice.
- And the electronic medical record (EMR) still has not developed into preventative tool it was conceived to be.
The biggest fear consumers now have in regard to their use of the healthcare system is a poor response and/or a bad outcome or result. Individuals are often afraid of the medicine or treatments they receive; they are also often afraid of the result if they do not use the medication or treatments. Every consumer should have concerns over using any and all of their medications in the best possible way.
Why? Because the medication that each of us use creates a result that can be very specific to each of us. There is a statistic that when an individual takes 2 medications, there is a 6% chance of medication related problems, and if taking 5 medications, a 50% chance, and if taking 8 medications, there is a 100 % chance that there will be medication related problems. This is especially true for younger and older patients as well as unhealthier patients. In the blink of an eye, any of us can easily take 8 or more medications, anything used for health—prescriptions, non-prescriptions, supplements, vitamins, minerals, etc.
Our use of medications has gotten very costly; even more costly when we address the cost of medication related problems. The cost of medication related problems, if treated as a disease or medical condition, rivals the cost of treating cancer, cardiovascular and Alzheimer’s diseases. Nationally, medication related problems are the 4th most costly “disease related condition”. Medication Related Problems are preventable or a least manageable and as such, if we are serious about managing our healthcare costs, medication related problems should be routinely and continually addressed by each of us.
Addressing medication related problems is more than keeping a “medication list”. While this is an important first step, it can in no way be deemed as a total solution. If your list of medications were the solution, simply placing your medications on a list and providing it to your healthcare prescribers would result in many fewer problems.
Medication use is just not that simple. Medications, prescriptions and all the other types of compounds used for health are sophisticated chemical compounds that affect other medications in use as well as every system in our body. The more medications, the more complicated the mix and
.my video tells my story… a the more likely we will have problems with our medications and our health. The most important concept in addressing medication related problems is to understand that your specific use of your medications, and that how you respond to them is as unique as you are.
Watch for next month’s blog where I will list the various ways our medication use can be complicated.