Advocating for Safe Medication Use

I had the honor in June 2023 to speak to caregivers on the topic of Advocating for Safe Medication Use, courtesy Aging Advantage in St. Louis, as part of their Family Caregiver Education program. The program was livestreamed on Facebook (the first time I’ve done something like that!), and you can access the full recording here.

Per Merriam-Webster, to advocate means “to support or argue for” a cause or policy, for example. In this case, the cause is safe medication use for yourself or a loved one. Why is this an important topic?

In today’s healthcare environment, more and more expectations are placed on patients and family caregivers to manage growing medication lists. Multiple limitations in the US healthcare system contribute to fragmented care and the potential for key safety issues, such as medication use, to fall through the cracks. The proportion of Medicare beneficiaries who see five or more physicians has increased from 19% to 35% since 2000 (Barnett, 2021). Problems arise when no one physician steps up to coordinate overall care for an individual patient. Without a universal electronic health record, communication can be missed along with opportunities to identify and correct medication errors and other problems. In most cases, there is no single health professional who is responsible for all the medications a person takes and for overseeing that person’s drug therapy to prevent harmful and unnecessary medication use.

Because of this, patients must take it upon themselves to be their own medication advocates. Older adults are more likely to experience an adverse drug event compared to younger adults and are more likely to require hospitalization because of the event. Too often, physicians do not critically look at a patient’s medication list with the aim of reducing or removing harmful or unneeded therapy. Medication lists may not be scrutinized until an adverse event has occurred, and even then, medications may be overlooked as a cause of the problem. By learning to be proactive in your health care and drug therapy decisions, you can reduce the risk of having a serious medication-related problem.

Here are some tips & strategies.

Recognize that you are the central member of your healthcare team. You have a voice and need to share with your doctors what matters most to you regarding your health care. Voice your preferences regarding medications. Would you rather take an additional medication or look first to other ways to manage your health condition before turning to drug therapy? Do you want to avoid injectable medications, or are you comfortable with needles? These are just some examples of how your preferences matter.

Communicate with your healthcare team about any concerns. It is the only way your clinicians can know your day-to-day experience and what challenges you have with taking your medications on a regular basis. You also need to share information between your different physicians. Do not assume that they are communicating with each other.

Share information with your pharmacist. Pharmacies generally have separate electronic databases that do not interface with the hospital or physician networks. Thus, pharmacists typically do not have access to your medical and medication information. It is essential that your pharmacist is aware of all the medications you take. Keep a complete and up-to-date medication list that includes not only prescription medicines, but also over-the-counter products and dietary supplements. (Stay tuned for a separate blog on medication lists.)

Finally, be informed. You need to understand your treatment options to participate in shared decision making with your physician. Here are four key questions that can be helpful:

What is my diagnosis? Be sure you understand the health condition and its causes.
What treatment options are available? Ask about medication as well as non-drug options.
What are the expected benefits of the drug therapy options? What are the possible harms?
What happens if you do not treat the condition?

Today more than ever, advocating for safe medication use is a necessary step to prevent medication-related problems and other serious errors.

If you want more guidance, tips, and strategies about safe medication use, check out my book, Maybe It’s Your Medications: How to Avoid Unnecessary Drug Therapy and Adverse Drug Reactions. It is available June 25, 2023, but please pre-order today from your favorite independent book store, Barnes & Noble, or Amazon! For monthly updates & strategies subscribe to my newsletter.

Written by Hedva Barenholtz Levy, PharmD, BCPS, BCGP

7-6-23

References:

Merriam-Webster Dictionary (on-line)

Barnett ML, et al. Trends in outpatient care for Medicare beneficiaries and implications for primary care, 2000 to 2019. Ann Intern Med 2021;174(12):1658-65. doi: 10.7326/M21-1523.

This material is intended to encourage discussion with your health care provider. It is informational only and does not replace the guidance of your health care team.