As we get older health troubles such as arthritic joints, raised blood pressure or failing hormones become more common and can result in a long list of medication. By the age of 75, most of us are on a regular prescription of some sort and at least a third take four or more drugs. Some of my patients need as many as 20 different drugs, with more than 30 daily doses.
Meanwhile, keen to do what we can to stay well, many of us take vitamins and supplements too. Vitamin C for protection against colds and flu, fish oils for creaky knees, calcium and vitamin D for strong bones are just some of the most popular. It’s easy to see how the pill pile grows. It can take a lot of juggling and the longer the list, the more likely that some medicines will interact with each other and not always in a good way.
So what can you do to manage your medicines efficiently? Read on for our top 10 ways to keep control of your pill count.
Book a review
First stop should be a ‘medication review’. In some surgeries this is done by the practice nurse or a pharmacist, but ideally it should take the form of a face-to-face review with your doctor to give you the chance to voice any concerns you may have as well as talk through any possible changes.
A review involves going through all your drugs and making sure each one is still needed, and in what dose. It should be done every 15 months if you are on repeat prescriptions, although for those at particular risk (for example if you are over 75 on more than four medicines) a six-monthly review is recommended.
Chat to a pharmacist
Get to know a local pharmacist too. Although your GP is the only one who can change your prescribed medicines, pharmacists are an invaluable source of useful information. They can also advise on over-the-counter medicines and help you to find the lowest effective dose.
If you are not taking a medicine as prescribed it’s time to be frank with your doctor, before they double the dose or start giving you additional drugs to try to control the problem. They may be able to suggest an alternative.
Don’t be afraid to stop taking a medicine if your doctor suggests it. You may be reluctant to change what you are used to, but your doctor will have a good reason. For example, the drug may no longer be doing its job or there may be newer drugs, which are better, safer or available in fewer doses. Never stop taking a medicine, however, without first checking with your doctor.
Look for an alternative
Are there any natural treatments, which you could try instead of medication, Head of Healthspan Nutrition says, “You may find you can manage constipation without taking drugs by altering your diet or by eating dried apples. Increasing vegetable roughage can also help.”
Focus on formulations
Ask your doctor about alternative formulations, which can be taken less frequently. For example, different types of the bone-protecting drugs called bisphosphonates are given at different intervals – some are daily, some weekly, some monthly and there is one that can even be given as an annual treatment. Other drugs come in slow-release formulations, which can cut the number of daily doses.
Ask about combinations
Another way to cut down your daily pill count is to take drug combinations where two or more medicines are included in the same tablet. This is a good option for vitamins and supplements too.
If you often forget to take your pills, there are plenty of helpful tactics to try. Tick off medicines on a calendar, programme alarms on your phone to alert you, or just follow a routine such as laying out tablets next to your morning cuppa. Also, talk to your pharmacist about a dossette box – plastic containers with compartments marked with the days of the week. Simply fill up the boxes at the start of the week with the day’s doses.
Regular health checks
These may indicate that in some instances you no longer need such intensive treatment. In later life, for example, low blood pressure can be a side effect of some drugs, which can lead to falls.
Once you have established the drugs you really can’t do without, try to take them as prescribed, to get the most benefit. Learn what each medicine is called and what it does, and keep a list in case of emergencies.
Interactions between drugs contribute to as many as one in five hospital admissions. Certain foods and supplements can cause problems with medication too.
- A list of things can interfere with the blood thinner warfarin, including cranberry juice, grapefruit and ginkgo.
- Calcium supplements can affect thyroid hormone therapy (levothyroxine) and certain heart drugs.
- St John’s Wort interacts with many medicines including antidepressants, warfarin, and digoxin. All should come with Product Information leaflets so make sure you read these.
Know your pills …
- Double check medicines at reliable websites such as NHS Choices www.nhs.uk/medicine-guides/pages/default.aspx
- Check the information leaflets provided with supplements.
- Ask your pharmacist about possible interactions when you collect a prescription.
- Always make sure your doctor knows which supplements you are taking.