How safe is your prescription?

How many people take medication because their doctor tells them to, without fully understanding what it is or why it has been prescribed? Pharmacist Ken Lee, author of How safe is your prescription?, advises what you should consider before filling your prescription.

As a second generation pharmacist I have seen many changes in the pharmacy profession. Sadly medication-related problems continue to frequently occur.

The good news is that many of these problems can be prevented through better advice and medication safety screening at the in store pharmacy level.

Medication safety is a significant health problem in Australia with approximately 500,000 people annually experiencing an adverse effect from a medication. It is estimated that around 190,000 hospital admissions each year are associated with problems using medicines, including harmful side effects¹. Also unsafe care is costly, with inappropriate use of medicines in Australia costing approximately $660 million per year in the public hospital system alone².

Many other studies have documented the extent of medication problems. When Australian researchers investigated unplanned admissions to Royal Hobart Hospital involving patients aged 75 years and older, it was found that 30 per cent may have been due to a medicine-related complication3. Researchers estimated that on the basis of their findings one third of people would require hospitalisation for an adverse drug reaction at some time in their lives. Over half of these cases investigated were considered to have been preventable.

If one half of medicine-related hospital admissions are preventable, then greater awareness of this and a team approach that incorporates patients, doctors and pharmacists can reduce patient suffering and ease financial burdens. Researchers in the United States have identified 48 classes of medication that should not be given to the elderly because of their risks and the costs of having to treat medication complications. It’s ridiculous to have all these life saving drugs but not be able to use them on the group of people who need them the most

Click ‘Next’ on the right to discover the key factors you should consider when filling your prescription:

Is this medication right for me?
You simply need to ask your pharmacist “What is this medication used for?” and confirm it with the condition you are treating. If it does not match your symptoms or simply does not make sense (some medications have multiple uses which may not be listed in the consumer information) ask your pharmacist or doctor BEFORE you take it.

Medication allergies can be deadly.
Once you know what you are allergic to, it’s important to let your doctor and pharmacist know. It’s also important to re-confirm this with them every time you visit. It can be dangerous to assume that your doctor or pharmacist has your complete and up-to-date medical history, despite the length of time you may have been visiting them.

Drug interactions are more common than you think
Medicines can interact with each other, with ‘natural’ therapies, and with food or alcohol. Complex medication interactions can result in serious health problems and must be closely managed by your pharmacist as there are several grades of significance. These grades can change over time, so it’s best that if you are taking multiple medications, you regularly have these interactions checked.

Pharmacists use drug interaction guides which are regularly updated to check if your medications interact. They will determine the severity and the best course of action for you if this happens.

Before, with or after food – it does make a difference
It’s amazing how food can react with drugs. If you enjoy an alcoholic drink you’ll know that, if you don’t eat and have a few drinks, the alcohol affects you more than if you had eaten. The increased alcohol levels in your blood when you don’t eat have been well documented.

Different medications have different reactions to food namely:

a. Food can bind with the medication and make it less potent or not effective at all. For example, with penicillin antibiotics.

b. Taking a medication with food can help reduce irritation of the stomach. For example Aspirin and other non-steroidal pain killers.

c. Certain foods can increase the potency of the medication in your system or create other problems eg. Plendil®, Zanidip® belong to a class of blood pressure medications called calcium channel inhibitors. Constituents of grapefruit can inhibit the metabolism of these drugs and markedly increase their clinical effects.

d. Alcohol is processed in the liver and so too are many other medications and drugs. Even low alcohol intake and regular use of somewhat harmless medications, like Paracetamol, can affect the liver.

Do I keep taking this medication forever?
The duration that you must take your medication for is often referred to as the “course” of treatment. Certain medications must be taken for the full course to work effectively (even though you may feel better) such as most antibiotics, medications for high cholesterol and blood pressure.

Other medications can be stopped after the symptoms disappear, such as some medicines for gastrointestinal problems, asthma reliever medication and pain medication.

It’s important to ask your pharmacist about the course duration because there is no point in taking medication that should be stopped; on the other hand, prematurely stopping medication results in your condition not being treated correctly.

Click ‘Next’ on the right to find out how to avoid medication problems

 

Medication problems can be avoided by asking your pharmacist some key questions. Your Pharmacist spends over four years studying medications and has many thousands of hours of clinical practice.

I suggest you seek out a pharmacist you trust who will readily complete the medication safety checklist below, or better still, a certified Chemconsult pharmacy who will complete a Chemconsult prescription safety check to be certain of complete safe guarding and maximum medication effectiveness and outcomes.

Your Prescription Safety Checklist

1. Please confirm this is the right medication for my condition, and give me a Consumer Medicine Information leaflet.
2. Please check my medication history for allergies to this medication.
3. Please check this is the correct dose for my age and weight.
4. Please explain if there are any drug interactions.
5. Please explain the side effects. What is normal and what is not normal?
6. Should I take the medication before or after food?
7. How should I store my medication?
8. Can I take alcohol while on this medication?
9. How long do I take this medication for?
10. What else can I do or take to help recover faster?

How safe is you prescription? By Ken Lee BPharm
http://www.hip.com.au/

RRP: $19.95

1. First National Report on Patient Safety- Improving Medication Safety and Quality Council July 2002
Second National Report on Patient Safety- Improving Medication Safety and Quality Council July 2002

2. Roughead EE, Semple SJ. Medication safety in acute care in Australia: where are we now? Part 1: a review of the extent and causes of medication problems 2002-2008. Aust New Zealand Health Policy. 2009 6: 18.
Semple SJ, Roughead EE. Medication safety in acute care in Australia: where are we now? Part 2: a review of strategies and activities for improving medication safety 2002-2008. Aust New Zealand Health Policy. 2009; 6: 24.

3. M. Chan, F. Nicklason and J.H. Vial, “Adverse drug events as a cause of hospital admission in the elderly”, Internal Medicine Journal, vol. 31, May/Jun. 2001, pp.199-205


Ken Lee

Ken Lee, BPharm, Pharmacist is founder and Managing Director of the Health Infor-mation Pharmacy group. He has a Bachelor of Pharmacy from Sydney University (1994) and is a member of the Pharmacy Guild of Australia. Health Information Pharmacy has won the prestigious Pharmacy of the Year award in New South Wales, ACT and Tasmania.

In 2000 he was nominated for Young Australian of the Year after founding the Chemcon-sult® prescription safety check system. Ken was the winner of the Young Entrepreneur of the Year (My Business Magazine) 2003.

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