N.H.'s Changing Workforce: The health and cost benefits of managing your meds
For people taking multiple prescription drugs and juggling prescriptions from different pharmacies and doctors, being an effective medication manager can be a daunting task. But the fact remains that equipping employees with the tools to successfully manage their medications is a simple and effective way employers can promote a healthy lifestyle and drive down health-care costs.
How well people manage their medications is "a huge determinant" of their overall health, says Cheryl Abel, pharmacist and assistant professor of pharmacy at the Massachusetts College of Pharmacy in Manchester. "I've seen many people whose health has declined as a result of improper use of medication."
Medication mismanagement is often the result of patients visiting different doctors and filling their prescriptions at different pharmacies. Because there is no communication among these entities, a patient may become overmedicated or take drugs that interact harmfully with each other - and that only compounds their illness, says Abel.
In some cases, "it's not the disease that's killing them, it's actually the side effects of the medication that is killing them."
Wise use of medications is about more than just the physical health of a patient. It's also essential to the financial health of both the employer and employee because of how quickly costs can mushroom as a result of medication misuse. Harmful drug interactions can leave employees feeling ill, resulting in lost productivity or absenteeism, says Abel.
"It can start as simple as not taking a medication properly, and can end up in a hospitalization," says Abel. "It can slowly snowball, and there are costs that come along with it."
One of the most effective and simplest ways patients can manage their meds is to keep a comprehensive list of medications they are taking, which physicians and pharmacists can check for any potential interactions.
Important to include on that list are over-the-counter medications, vitamins and supplements.
"Over-the-counter medications which don't require prescriptions are just as dangerous and have just as many potential issues as prescription medications," says Abel. "A lot of people think that because you can go in the store and buy it, it's safe, but that's not true."
Patients should make copies of this list and keep it in their wallet, at home, in their cars and with a caregiver, in case they ever should become involved in an accident where their medication history is required for treatment, says Abel.
"I can't tell you how often in the pharmacy we get calls from emergency rooms saying, ‘We have this patient here, we need to know what they're taking, we need to treat them but we don't know what they're on,'" says Abel.
If possible, taking all prescriptions to a single pharmacy can help to eliminate potential prescription problems, she says.
It's also essential for patients to ask questions of their health-care providers. Abel recommends that patients request 15 extra minutes with their doctor to ask questions about their prescriptions, such as the drug's purpose, its side effects, whether it's safe to take with other meds, when and how to take it and whether there is a similar, lower-cost alternative.
Patients also should ask the same questions of their pharmacists, who patients need to think of "as part of their health-care team," says Jamie Bulen, associate state director of communications at AARP New Hampshire.
"(Pharmacists) are the most accessible health-care provider, we're on every corner of the city, we're open 24 hours most of the time," says Abel. "We can also sit down and take all those pieces from all those prescribers and look at it as an overall big picture."
In addition to keeping an up-to-date list of current medications and asking the right questions, there are other measures patients can take to become better medication managers.
For one, they should never take drugs that are expired, which Abel compares to drinking milk past its due date.
In addition, sometimes "lifestyle modifications can take the place of medications," says Abel, citing the story of a diabetic woman on a whole host of medications who cured her diabetes by losing 70 pounds - and, in the process, saved money on drugs.
Switching to generics also can save money for both insurers and the insured.
When a patient chooses a name-brand drug over a generic, it costs insurance companies more and can drive premiums up. To keep costs down, Abel recommends using lower-cost generic drugs when they are available. In New Hampshire, a patient can choose the generic even if a doctor has prescribed the brand name.
"People really just have to be their own advocate," says Abel. "They have to stand up for themselves because there's nobody that's doing it for them."
For more information and to obtain an AARP Medication Management Toolkit, which includes a personal medication record and a 15-minute DVD titled "Your Medicines and You" featuring internationally known geriatrician Dr. Bill Thomas, visitaarp.org/nh/meds.
N.H.'s Changine Workforce series is a collaboration between NHBR and AARP New Hampshire. Kathleen Callahan can be reached at firstname.lastname@example.org.