Medication challenges

by Mary Macdonald BSN, RN

Updating medication lists can be a challenging task for patients, nurses, and physicians.  Medications are the major factor in treating illnesses and disease, but when not taken properly patients are at risk for adverse events and poor outcomes.  The cost of medications have increased over the years as well as the cost of treating patients who become hospitalized due to non-adherence of medication, improper use, or lack of understanding.   Not every patient will respond or react to a medication in the same way, and not every potential side effect will happen when a new medication is tried.  Communication is essential for the patients, caregivers, nurses, and physicians regarding medication adherence.  Too often medications are stopped or started without direct contact to a physician, which can result in a dangerous outcome.  Taking an old antibiotic from your cabinet seems like the logical thing to do for a cold or suspected urinary tract infection, but in reality, in may do more harm than good to self-medicate.  Viruses don’t respond to antibiotics and the growing problem of antibiotic resistant bacteria is a major concern today.   Many people with high blood pressure have had their medications changed repeatedly and accumulate quite a supply of “old” medication in their cabinets.  There are times when someone may run out of a prescription so they restart an old medication, thinking better to take something than nothing.  Side effects drive people to change out their current prescriptions with an old one as well.  This is all understandable, but communicating the problem to the nurse or physician is important for health and safety reasons.  The old medications were stopped for good reason and there is the possibility of a drug interaction with a new medication to be aware of.  Pharmacies interchange name brand drugs for generic, which causes confusion as well, as some may not realize they may actually be taking two of the same drug if they are not vigilant.   One of the greatest challenges we face on a daily basis with updating medications is the misconception that all Electronic Medical Record Systems are communicating with each other.   This is the long-range plan for the electronic system, but unfortunately, we are not there yet.  Some assume that because one doctor changed a medication any other doctor taking part in their care automatically knows about the medication change.   For better health outcomes and safety we continue to review medications one by one at each visit.  Bringing in your most recently updated medication list, or even your actual pill bottles, is the best way for us to know what medications you are presently taking,