Medications compliance and management

MANAGING YOUR MEDICINES

To get the full benefit and reduce risks in taking your medicines, it is important to follow instructions exactly. This means taking the right medicine and dose, at correct time intervals, for the length of time prescribed. Bad effects can result from taking too much or too little of a medicine, or taking it too often or not often enough.

BLISTER PACKAGING

Sukhi Lalli Pharmacist and many other pharmacies will blister pack your medications to help you take them more effectively. What this system does is package each dose individually with the time of day and day of the week it is to be taken clearly indicated. With this system, if you can't remember if you have taken your medication or not, you simply look at the approx 8 x 11 inch card that one week's meds are packaged in, and if your last dose is still in it's blister, then you know you still need to take it. Many people use this system and find thier medications become more effective and that they suffer from less side effects simply by taking the pills when they re supposed to be taken. Please call or email us for more information.

ESTABLISHING A SYSTEM

Whether you are taking one or several medicines, you should develop a system for taking them. It can be just as difficult to remember whether you took your once-a-day medicine as it can be to keep track of a number of medicines that need to be taken several times a day. Many medicines also have special instructions that can further complicate proper use.

Establish a way of knowing whether you took your medicines properly, then make that a part of your daily routine. If you take one or two medicines a day, you may only need to take them at the same time that you perform some other regular task, such as brushing your teeth or getting dressed.

For most people, a check-off record can also be a handy way of managing multiple medicines. Keep your medicine record in a handy, visible place next to where you take your medicines. Check off each dose as you take it. If you miss a dose, make a note about what happened and what you did on the back of the record or the bottom of the sheet.

Be sure to note any unwanted effects or anything unusual that you think may be connected with your medicines. Also note if a medicine does not do what you expect, but remember that some medicines take a while before having a noticeable effect.

If you keep a check-off record faithfully, you will know for sure whether or not you took your medicine. You will also have a complete record for your health care professionals to review when you visit them again. This information can help them determine if the medicine is working properly or causing unwanted side effects, or whether adjustments should be made in your medicines and/or doses.

If your medicines or the instructions for taking them are changed, correct your record or make a new one. Keep the old record until you are sure this information is no longer needed.

You might want to color-code your medicine containers to help tell them apart. If you are having trouble reading labels or if you are colorblind, codes that can be recognized by touch (rubber bands, a cotton ball, or a piece of emery board, for instance) can be attached to the container. If you code your medicines, be sure these identifications are included on any medicine record you use. If necessary, ask your pharmacist to type medicine labels in large letters for easier reading.

A check-off list is not the only method for recording medicine use. If this system does not work for you, ask your health care professional for help in developing an alternative. Be sure he or she knows all the medicines prescribed for you and any nonprescription medicines you take regularly, the hours you usually eat your meals, and any special diet you are following.

Informed management

Your medicines have been prescribed for you and your condition. Ask your health care professional what benefits to expect, what side effects may occur, and when to report any side effects. If your symptoms go away, do not decide you are well and stop taking your medicine. If you stop too soon, the symptoms may come back. Finish all of the medicine if you have been told to do so. However, if you develop diarrhea or other unpleasant side effects, do not continue with the medicine; call your health care professional and report these effects. A change in dose or in the kind of medicine you are taking may be necessary.

When you are given a prescription for a medicine, ask the person who wrote it to explain it to you. For example, does "four times a day" mean one in the morning, one at noon, one in the evening, and one at bedtime; or does it mean every six hours around the clock? When a prescription says "take as needed," ask how close together the doses can be taken and what the maximum number of doses you can take in one day should be. Does "take with liquids" mean with water, milk, or something else? Are there some liquids that should avoided? What does "take with food" mean? At every mealtime (some people must eat six meals a day), or with a snack? Do not trust your memory — have the instructions written down. You must understand exactly what the prescriber wants you to do in order to "take as directed."

When the pharmacist dispenses your medicine, you have another opportunity to clarify information or to ask other questions. Before you leave, check the label on your medicine to be sure it matches the prescription and your understanding of what you are to do. If it does not, ask more questions.

The key to getting the most from your prescribed treatments is following instructions accurately and intelligently. If you have questions or doubts about the prescribed treatment, do not decide to stop taking the medicine or fail to follow the prescribed regimen. Discuss your questions and doubts with your health care professional.

The time and effort put into setting up a system to manage your medicines and establishing a routine for taking them will pay off by relieving anxiety and helping you get the most from your prescribed treatment.

TAKING YOUR MEDICINE

To take medicines safely and get the greatest benefit from them, it is important to establish regular habits so you are less likely to make mistakes.

Before taking any medicine, read the label and any accompanying information. You can also consult books to learn more about the medicine. If you have unanswered questions, check with your health care professional.

The label on the container of a prescription medicine should bear your first and last name, the name of the prescriber, the pharmacy address and telephone number, the prescription number, the date of dispensing, and directions for use. Some provinces may have additional requirements. If the name of the drug product is not on the label, ask the pharmacist to include the brand (if any) and generic names. An expiration date may also appear. All of this information is important in identifying your medicines and using them properly. The labels on containers should never be removed, and all medicines should be kept in their original containers.

Some tips for taking medicines safely and accurately include the following:

Read the label of each medicine container three times: (1) before you remove it from its storage place, (2) before you take the lid off the container to remove the dose, and (3) before you replace the container in its storage place.
Never take medicines in the dark, even if you think you know exactly where to find them.
Use standard measuring devices to take your medicines (household teaspoons, cups, or glasses vary widely in the amount they hold). Ask your pharmacist for help with measuring.
Set bottles and boxes of medicines on a clear area, well back from the edge of the surface to prevent containers and/or caps from being knocked to the floor.
When pouring liquid medicines, pick up the container with the label against the palm of your hand to protect it from being stained by dripping medicine.
Wipe off the top and neck of bottles of liquid medicine to keep labels from being obscured, and to make it less likely that the lid will stick.
Shake all liquid suspensions of drug products before pouring so that ingredients are mixed thoroughly.
If you are taking medicine with water, use a full, 8-ounce glassful, not just enough to get it down. Too little liquid with some medicines can prevent the medicine from working properly, and can cause throat irritation if the medicine does not get completely to the stomach.
To avoid accidental confusion of lids, labels, and medicines, replace the lid on one container before opening another.
When you are interrupted while taking your medicine, take the container with you or put the medicine out of the reach of small children. It only takes a second for them to take an overdose. When you return, check the label of the medicine to be sure you have the right one.
Crush tablets or open capsules to take with food or beverages if your health care professional has told you that this will not affect the way the medicine works. If you have difficulty swallowing a tablet or capsule, check with your health care professional about the availability of a different dosage form.
Follow any diet instructions or other treatment measures prescribed by your health care professional.
If at any point you realize you have taken the wrong medicine or the wrong amount, call your health care professional immediately. In an emergency, call your local emergency number.

When you have finished taking your medicines, mark it down immediately on your medication calendar to avoid "double dosing." Also make note of any unusual changes in your body, including change in weight, color or amount of urine, perspiration, or coughed-up matter; as well as your pulse, temperature, or any other items you may have been instructed to observe for your condition or your medicine.

Try to take your medicines on time, but a half-hour early or late will usually not upset your schedule. If you are more than several hours late and are getting close to your next scheduled dose, check any instructions that were given to you by your health care professional. If you did not receive instructions about missed doses, check with your health care professional.

When your medicines are being managed by someone else (for example, when you are a patient in a hospital or nursing home), question what is happening to you and communicate what you know about your previous drug therapy or any other treatments. If you know you always take one, not two, of a certain tablet, say so and ask that your record be checked before you take the medicine. If you think you are receiving the wrong treatment or medication, do not hesitate to say so. You should always remain involved in your own therapy.

Many hospitals and nursing homes now offer counseling in medicine management as part of their discharge planning for patients. If you or a family member is getting ready to come home, ask your health care professional if you can be part of such instruction.

‘expiration date’ on medicine labels

To assure that a drug product meets applicable standards of identity, strength, quality, and purity at the time of use, an "expiration date" is added by the manufacturer to the label of most prescription and nonprescription drug products.

The expiration date on a drug product is valid only as long as the product is stored in the original, unopened container under the storage conditions specified by the manufacturer. Among other things, humidity, temperature, light, and even air can effect drugs. A medicine taken after the expiration date may have changed in potency or may have formed harmful material as it deteriorates. Contamination with germs can also occur. The safest rule is not to use any medicine beyond the expiration date.

PREVENTING DETERIORATION

A drug begins to deteriorate the minute it is made. The manufacturer, in calculating the expiration date, factors in this rate of deterioration. Keeping the drug product in the container supplied by the pharmacist helps slow down deterioration. Storing the drug in a proper manner — for example, in a light-resistant container or in a cool, dry place (not the bathroom medicine cabinet) — also helps. The need for medicines to be kept in their containers and stored properly cannot be overstressed.

Patients sometimes ask their health care professionals to prescribe a large quantity of a particular medicine in order to "economize." Although this may be all right in some cases, this practice may backfire. If you have a large supply of your medicine and it deteriorates before you can use it all, or if your doctor changes your medicine, you may lose out.

Sometimes deterioration can be recognized by physical changes in the drug, such as a change in odor or appearance. For example, aspirin tablets develop a vinegar odor when they break down. These changes are not true of all drugs, however, and the absence of physical changes should not be assumed to mean that no deterioration has occurred.

Some liquid medicines mixed at the pharmacy will have a "beyond use'' date on the label. This is an expiration date that is calculated from the date of preparation in the pharmacy. This is a definite date, after which you should throw away any remaining medicine.

If your prescription medicines do not bear an "expiration" or "beyond use" date, your dispensing pharmacist is the best person to advise you about how long they can be safely used.