Are You Taking More Meds Than You Need?
Taking too many medications can diminish rather than enhance your quality of
life.
By Roger P. Austin, MS, RPh, CDE

Do you take so many medications that you have trouble keeping track of them
all? If so, you're not alone. In fact, the problem is so common that it has
a scientific name: polypharmacy. (Poly means many; pharmacy means drugs.)

Taking many medications every day is particularly common when you have a
chronic disease like diabetes, because you are likely to be treating several
conditions at the same time. For instance, in addition to oral agents or
insulin for managing your diabetes, you might be taking something for high
blood pressure, cholesterol, heart disease, and perhaps even depression.

Add other common conditions, such as arthritis, glaucoma, asthma, or even
headaches, not to mention vitamins and minerals, and your medicine chest
could start looking like a small pharmacy.

While most medications are helpful, when you take many of them on a daily
basis, it's important that you become familiar with each of them and know
how to take them correctly. If not, you could be letting yourself in for
serious trouble.

For one thing, when you're taking many different pills, it's much easier to
take the wrong one. Being in a hurry, feeling tired, not wearing your
glasses, forgetting which pill you took earlier, confusing one pill-or one
pill container-for another all can cause you to do this.

Also, the medications you take can interact with each other. And the more
meds you take, the greater the chance that the interaction could be harmful.

Where Did All My Pills Come From?
Several factors can lead to polypharmacy.

You might have an internist or family physician for your general medical
care, an endocrinologist for your diabetes control, and a cardiologist for
your heart, all of whom prescribe different medications-perhaps more than
one. You may also be taking vitamins, minerals, and over-the-counter
medicines on your own.

Again, taking several medications is not unusual when you are treating
several conditions at the same time. But when one doctor prescribes a
medication-even for a cold or the flu-without knowing what other doctors
have prescribed and what over-the-counter products you are also taking,
problems can arise.

Age is another factor. It's no secret that, as we get older, we tend to
develop new medical conditions. Some may be related to diabetes and some may
simply be related to the aging process. But any or all of them could add
more medications to an already crowded medicine cabinet.

Then there are the growing number of direct-to-consumer drug advertisements.
We get hit with them every time we open a magazine, turn on the TV, or log
onto the Internet. Their exciting promises encourage us to add still more
pills to our regimen.

Although it doesn't happen often, it's also possible for a doctor to
misdiagnose your reaction to a drug. He or she may conclude that you have a
totally new condition, and prescribe yet another drug for the "new"
difficulty.

How Do I Avoid The Problem?
There are a number of things that you can do to reduce your risk of
polypharmacy.

First, prepare a complete list of all the medications you are taking.
Include over-the-counter as well as prescription medicines, even those you
take only occasionally. Don't forget vitamin or mineral supplements, herbal
products, external medical ointments, and food supplements.

Next to the name of each medication, add the strength (for example, ounces
or milligrams), dosage form (such as capsule or liquid), directions for use
(for example, "take with food" or "take before bed"), and the reason you are
taking the medication (such as high blood pressure, kidney disease, or heart
disease).

Also include the date you started taking each medication and the name of the
doctor who prescribed it.

Talking To Your Doctor
Make sure each doctor you see regularly, especially any who prescribe
medications for you, has an up-to-date list of all your meds. If not, hand
one to him or her and ask that it be kept in your file.

Also ask to review your pill regimen together so you understand why you are
taking each medication.

Remind your doctor how long you have been taking each medication. Some
diabetes drugs, for example, may no longer be working as well for you today
as they did when you started taking them. Or, perhaps a newer, more
effective drug is now available.

Also, if your doctor wants you to start taking another medication, ask if
there is any other you might be able to discontinue.

Be sure to tell your doctor if you forget to take your medicines and how
often this may happen in the course of a week. Also, tell your doctor if
your medication schedule is difficult to follow. In some cases, he or she
might be able to switch you to a combination medication, which would reduce
the number of pills you take, or to a drug that could be taken once a day
instead of several times a day.

Certainly tell your doctor if you seem to have any side effects from a
medication.

Mention any lifestyle changes you've made recently, especially regarding
eating patterns or physical activities. They may also affect the medications
or doses you take.

Taking the time to understand your drug therapy will help you and your
doctor make sure you stay in the best of health.

Roger P. Austin, MS, RPh, CDE, is a clinical pharmacist with the Henry Ford
Health System in Sterling Heights, Mich.

Participate In Your Medication Decisions
 a.. Keep an updated list of all your prescription and non-prescription
medications. Take the list (or the medications) to every doctor's
appointment.
 b.. Review your medications list with each new doctor you visit.
 c.. Ask your doctor why he or she is adding, dropping, or changing a
medication or dose.
 d.. Remind the doctor of other medications you are also taking.
 e.. Tell your doctor about any changes in your lifestyle, especially
regarding your eating patterns or exercise regimen.
 f.. Discuss the possibility of using a generic form of a drug, especially
if the name brand is expensive. (Even if your insurance covers the cost,
everyone who contributes to the insurance ultimately pays for the drugs.)
 g.. Have your prescriptions filled at the same pharmacy each time.
 h.. Get to know your pharmacist and ask him or her questions about your
medicines.
 If You Are Using Insulin
 a.. Ask your certified diabetes educator to review your injection
technique from time to time.
 b.. Show him or her how you prepare your insulin, measure your doses, and
rotate your injection sites.
 c.. Tell the educator when, and how much, you inject in relation to meals.
 d.. Make sure that you understand completely how the insulin you are using
works in your body. How quickly does it peak? How long does it work? How
does it affect your blood glucose levels if you skip meals or sleep in on
weekends and get off your dosing schedule?