Tribune Print Share Text

Prescription bottles everywhere:

How to keep track of all those pills

Created date

April 24th, 2012

Are up up to your neck in pill bottles? You re not alone. According to a University of Chicago Medical Center study, over half of older adults take five or more medications and/or supplements. Researchers also found that at least 5% of study participants take drugs incorrectly or in combinations that can cause harmful drug reactions.

Mistakes happen

If you can t take your medicines correctly, it s not because you are old and forgetful. Older people may in fact have mild dementia, which can interfere with the ability to keep up with their medication schedule, says Leslie Rigali, D.O., medical director at Brooksby, an Erickson Living community in Peabody, Mass. But I ve also known older patients who are mentally sharp who still make mistakes. An ever-changing medication schedule is often the culprit. Some medications, such as anticoagulants, are stopped, restarted, or the dose is changed based on lab work, Rigali says. You may have different bottles with different dosages around the house. Or if a medicine for a particular condition is changed, such as one blood pressure pill for another, people might keep their old prescriptions around and mix them up accidentally, she adds.

Simplify the problem

Keeping track of multiple sets of instructions on several medications is enough to confuse anyone. Weekly planners, calendars, and pill boxes are essential tools, Rigali says. Otherwise, at lunchtime you may forget if you took your medicine that morning. If you are taking something crucial such as a heart pill, missing a dose or taking it improperly can kill you, Rigali explains. Have someone else set up your pillbox if you can t keep track. You may qualify for regular checks at home by a home health nurse or medicine aide, or you can ask a family member or friend to call to remind you. If you still can t keep up with it, perhaps your doctor can simplify your schedule. For instance, something you take twice a day may be changed to once a day.

Out with the old

To minimize the clutter, discard expired medicines. Adhere strictly to expiration schedules on prescription medication, Rigali says. Drugs may not necessarily become harmful after a certain date, but they may be less effective. In the case of chronic conditions such as diabetes or high blood pressure, a less effective drug can be dangerous, says Timothy West, Pharm. D., clinical pharmacy coordinator at Mercy Medical Center in Baltimore, Md. If you reach for an expired nitroglycerin pill when you are having chest pain, it may not work. With over-the-counter drugs, it s usually safe to go beyond the expiration date within reason, Rigali says. If a drug such as Tylenol (acetaminophen) becomes less potent, it s not going to significantly affect your health. According to the American Society of Health System Pharmacists, if you re unsure about an expiration date, consider medications expired after six months. Ask your pharmacist about how to dispose of old medicines. It s no longer accepted practice to flush everything down the toilet, West says. Check around your community for prescription disposal centers or services.

What the directions really mean

Suppose your bottle reads, take three times a day. Does that mean every eight hours or at breakfast, lunch, and dinner? You may not know unless you ask. Always clarify with your doctor the exact directions for drugs that you take more than once a day, Rigali advises. Certain drugs, such as antibiotics, work best when taken at regular intervals, West explains. What if you have five medications that you take only once a day? It s not necessarily safe to take them all at once, West says. Some medications may interact with others. Always ask your doctor or pharmacist which ones you can take at the same time.

Avoid harmful interactions

Bring all medications and supplements with you when you go to the doctor s office, any specialist s office, or hospital. Always use the same pharmacy, but if you have to use a different one, take a medication list with you, Rigali advises. Look carefully at the medicine itself, not only the label. If it looks different from what the printout indicates or if something doesn t seem right, ask your pharmacist about it. According to the Agency for Healthcare Research and Quality, most errors of this type are first discovered by patients. Even if you ve been taking the same drug for years, always read the printed material that comes with it, West says. Pharmaceutical companies update important information periodically.