a bottle of pills

Pharmacist knows best: How to avoid medicine misuse

Preservation of life, or pikuach nefesh, is a central Jewish principle. I am excited to bring you this column to fulfill this mitzvah of life preservation.

October is Talk About Your Medicines Month as well as American Pharmacists Month, so now is a good time to learn about how to avoid medication misuse.

The “other drug problem” — namely, the misuse of prescription and nonprescription medicines and dietary supplements — is more common in seniors because, among other things, they use the most medicines.

Elders and drugs. Seniors make up about 13% of the population but consume a third of all prescription drugs. Nine out of 10 Americans over age 80 use prescription drugs, filling 22 prescriptions annually, on average. Almost half report they also use an over-the-counter product or dietary supplements. More than 80% of older patients (57 to 85) use at least one prescription medication daily, with more than half taking more than five medications or supplements daily.

Misuse and impact. Some 20% to 30% of medication prescriptions are never filled, and about half of medications for chronic disease are not taken as prescribed. About 125,000 deaths per year in the United States and one-third to two-thirds of medication-related hospital admissions are due to poor medication adherence.

Besides poor disease control, medication misuse can result in adverse drug reactions. Each year, more than 9.6 million adverse drug reactions occur in older Americans. Many are preventable. Hundreds of thousands of these adverse drug reactions result in hospitalization. The direct and indirect cost estimates for medication nonadherence is in the hundreds of billions of dollars.

Misuse spelled out. Older adults are more prone to medication misuse since they take multiple medicines often several times a day, and may have poor vision, hearing and memory (making it hard to follow directions).

Some people skip doses to save money, do not complete a course of therapy or simply do not take their medicines. They may take the wrong dose, causing undertreatment or toxicity. Also, consumers sometimes turn to unreliable sources for medication advice. They may borrow medicines from others, or take over-the-counter medicines and herbal products with their prescription medicines, not knowing the potential for drug interactions.

Additionally, medicines prescribed by multiple health care providers can create confusion. That’s why it’s good to frequent one pharmacy, so they can keep track of all your medicines and screen for potential drug duplication and interactions. Your pharmacist can also explain medication directions, identify side effects to watch for and report, and suggest equivalent, less-expensive generic medications when appropriate.

Good habits. Here are ways to avoid medication misuse and its negative health consequences:

  • Read and follow drug label instructions carefully and ask your pharmacist if you have questions.
  • Be aware of interactions with other drugs, foods and beverages, such as alcohol.
  • Be able to recognize potential side effects, and know what to do if they occur.
  • Check with your health care provider before stopping or changing a drug regimen.
  • Do not borrow medicines from others or loan your medicines to others.
  • Be aware of precautions, such as if you can drive or the need to avoid the sun.
  • Store medicines safely in original, child-proof containers, in a locked cabinet away from children.
  • Follow FDA guidelines on how to discard unused or expired medicines.
  • Carry an updated medication list to show to your health care provider and pharmacist. (Download the free “My Medication List” from DrLinda.tv.)
Dr. Linda Bernstein
Dr. Linda Bernstein

Linda Bernstein, Pharm.D., hosts “Dr. Linda TV – Best of Health!” on YouTube. Her website and blog are at DrLinda.tv. She is a volunteer clinical professor at the UCSF School of Pharmacy.