Dapo Ogunbayo
11th July 2017

Medication, Medication, Medication

 

What is important to older people, family members and members of the public about taking multiple medicines and how research can help address these concerns?

Discussion themes

-          Taking prescribed and non-prescribed medicines - how many medicines is ‘too many’?

-          When to stop taking medicines?

-          Getting help and support about medicines from both health and non-health sources?

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What Do You Think?

Discussion

  • Dapo Ogunbayo
    1st August 2017

    Once again, many thanks for all your contributions on this topic. Medicines are the most important intervention that the NHS provides and will continue to make a massive difference to improving our quality of life.

    One thing that is apparent from these discussions is that there are differences between patients and healthcare professionals’ perceptions of “how patients work with their medicines” (as opposed to “how medicines work for them”).

    While many of the issues raised are well recognised in research, there is still a significant gap in what needs to be done to tackle these issues. Many patients learn to ‘self-manage’, ‘adapt’ and ‘experiment’ with or without the input of their healthcare professionals.

    There are however a lot of information, support services and interventions that can make a difference in addressing many of these issues. From a research angle, we need to improve our understanding of how to tackle these issues from the perspectives of patients, rather than from the perspective of healthcare professionals.

    Part of my research work is focussed on disentangling many of these problems to provide evidence-based solutions that also incorporates ‘the patient voice’. Please feel free to get in touch with me about the research I’m doing.

    Thank you!

    Dapo

  • Irene Soulsby
    30th July 2017

    Perhaps a final posting on tablet packs! One lot of meds had 14 per sheet (1 per day) but the new equivalent has 7 per sheet (different layout) and another lot of meds had 10 per sheet (I used to use these for weekdays and then another sheet for the two days at the weekend) but the new layout has 15 to a sheet, so I will use 5 down the sheet for week days and then the ones side by side for the weekend) Just so I can remember what I have taken!

    Dapo Ogunbayo
    1st August 2017

    Wow! Many healthcare practitioners have no idea of the type of innovative things that people do just to remember to take their medicines!!

  • Irene Soulsby
    27th July 2017

    Perhaps the future is also an "Intelligent Robot Health Advisor" that can draw on vast amounts of information and this will give a more accurate picture of our health and what is needed. Perhaps a way to pass on messages to the patient. It may seem strange to us now, but I wonder how life will be like in 50 years - I have already seen changes in technology, healthcare, in my lifetime. We now have robotic surgery where someone in France can operate on someone in the States! Very sci-fi!

  • Irene Soulsby
    27th July 2017

    I know also that there are certain sites that you should go to for health advice, but there are also a lot of sites that do not give good or accurate advice!

  • Irene Soulsby
    27th July 2017

    What also happens if people take supplements (an unknown quantity and mixture), might these interfere with meds?

    Dapo Ogunbayo
    27th July 2017

    It depends on the type of supplements, but they can generally interfere with some meds and most should be used with caution and on the advice of the pharmacist or GP.

    In addition, supplements can also increase the workload of the liver and kidney, and these organs may already be getting stressed due to old age or presence of other conditions. Hence, care should always be taken when using medicines that are not prescribed in addition to other prescribed medicines.

    There is a research gap on the impact of these 'non-prescribed' medicines and how they are used by older adults who are already using many prescribed medicines.

    I would appreciate any comments or shared experiences of the use of 'non-prescribed' medicines by everyone on this forum as I laid out in my post yesterday. Thank you.

    Irene Soulsby
    27th July 2017

    Leave a reply...I think that people pop into places like Holland and Barrett and read the containers or info on shelves and think "Oh, they look good, I'll try those". It would be interesting to know how many people do use supplements as well as their meds - that would be a really interesting project! I know when I was younger, I did shop for lots of vitamins and supplements and paid a small fortune every month, not aware of over-dosing or if they really worked. You tend to get sucked in with the promotions and the reviews!

  • Irene Soulsby
    27th July 2017

    I've just looked at a prescription which is at home (not mine, but I guess a lot will be similar) and it has on it "Review Date Overdue: 21 Jan 2015". Is it up to patient to request review with doctor or should Practice contact patient? Going on for 3 years now.

    Dapo Ogunbayo
    27th July 2017

    It is possible that the practice might have tried to contact the patient but the patient could also proactively request for the review, particularly if there are concerns (such as stockpiling or 'too many medicines').

    As I said yesterday, healthcare is now moving towards patients being more proactive and taking more responsibility such as this. What do people think about this?

    Irene Soulsby
    27th July 2017

    I haven't been to the doctors for awhile and will certainly ask about my repeat prescriptions in future! Perhaps that is the same for others and perhaps we don't remember to ask if our meds should be reviewed again. If the reminder is printed on the prescription and isn't actioned, do you think it is time for a letter from the Practice (or text message reminder?) I think the "review overdue" message gets a bit lost on the prescription or you think that you'll get round to it sometime! I must admit I didn't notice the message was actually on there til I had a better look!

  • Dapo Ogunbayo
    27th July 2017

    Good morning everyone and many thanks for all the really interesting contributions. They've been really insightful for me and I hope you have also found the topic useful?

    I am keen to hear your views about the use of "non-prescribed" medicines by those already on medicines that were prescribed by their doctor.

    "Non-prescribed" medicines include those that are bought at the pharmacy/chemist without a prescription. It also includes medicines that are bought via the internet or those that were recommended by friends or family members (children, grandchildren). Herbal medicines and dietary supplements could also be classed as "non-prescribed" medicines.

    I would welcome a wide range of views and experiences about non-prescribed medicines, but here are a few questions to get you thinking:

    - Do you discuss these with your doctor in relation to other medicines?

    - Do doctors or pharmacists ask about them during your routine appointments?

    - Have you had any problems with these medicines and what actions did you take?

    - How do you get these "non-prescribed" medicines?

    Thank you!

  • Irene Soulsby
    25th July 2017

    My friend's mother has dementia, lives alone apart from family who call in to see her . My friend would pop in to sort out tablets for the week and put in pill container. However, when she called in to see if her mother was doing ok, her mother was getting days mixed up for tablets, ie perhaps taking Thursday's dose instead of Tuesday and also taking all the tablets of one colour (for example) When they realised this was happening, they had to think again about tablet dispensing in this way.

    Dapo Ogunbayo
    26th July 2017

    Managing and use of medicines by older adults (and their families) who live with dementia, who live alone at home and/or who have other complex needs is a growing public health challenge. Although this is well-recognised in health policy and research, an important and often neglected area is the perspective of those who actually live with and experience these problems.

    One of the aims of this (and other) discussion forum is to help in shaping the type of research questions that are being asked from the patient/family perspective. Many thanks for sharing this Irene.

    Would you be able to signpost your friend to this discussion forum to contribute on how this issue has been resolved? I would hope that a more effective/better system has been put in place to ensure that the medicines are now being dispensed and used more appropriately. Speaking to the pharmacy and/or GP would certainly be helpful.

    Irene Soulsby
    27th July 2017

    will mention the forum to her and hopefully she'll join in

  • Bianca Tobin
    24th July 2017

    On a somewhat different note, when on regular medication a repeat prescription service may save on appointment times; however, from personal observation and personal experience this may lead to many costly medications going to waste and costing the NHS millions because the medications are stockpiled and often expire before being used. I had to go to the pharmacy and ask for prescribing to be put on hold for a period of time. When I returned to request my prescriptions be reinstated, I was told that I would have to see my GP before it could be recommenced. I think a new system could be instigated whereby repeat prescriptions be terminated every three/six months and an appointment booked at that time. A reminder would be sent the week before and attendance would allow for review and renewal of the medication/s. This would prevent what may well be massive costly wastage of medications. The money saved and could be used to improve staffing levels in hospitals.

    Irene Soulsby
    25th July 2017

    Yes, I wonder about the message "due for review" on prescriptions - sometimes mine is years out of date! (also are pharmacists now promoting their input in medication?) I think also you get a "replacement" medication from time to time and sometimes patients don't think that the substitute works as well as their normal meds. (ie sometmes substituted because of cost)

    Dapo Ogunbayo
    26th July 2017

    Many thanks Bianca and Irene for your contribution on this topic. You are absolutely correct, Bianca, about how much medicines wastage occurs in the system, which is ironical since the repeat prescription system was put in place to cut costs associated with reduced appointment times!

    This is a well-recognized problem and I know that many GPs and pharmacies are now working together to develop more efficient systems. But again, the views and suggestions of patients who experience these issues are often lacking which leads to a breakdown in the system. Are there any ways that you think that the ‘patient voice’ can be heard more loudly?

    I know government policies around the concepts of ‘self-care’ ‘patient-centred care’ and ‘patient involvement’ suggests that patients and their families should also take on some more responsibilities in tackling these issues. Some of these responsibilities may include patients being more ‘proactive’ in scheduling their medication reviews rather than wait to be contacted by the GP. What are thoughts about this?

    Irene, I think the issues of how patients may sometimes think that replacement/substitute medications work or don’t work may be down to how the change is communicated during dispensing. What do you think, and have you had an experience of this?

    Thanks both.

    Dapo Ogunbayo
    26th July 2017

    Many thanks Bianca and Irene for your contribution on this topic.

    You are absolutely correct, Bianca, about how much medicines wastage occurs in the system, which is ironical since the repeat prescription system was put in place to cut costs associated with reduced appointment times!

    This is a well-recognized problem and I know that many GPs and pharmacies are now working together to develop more efficient systems. But again, the views and suggestions of patients who experience these issues are often lacking which leads to a breakdown in the system. Are there any ways that you think that the ‘patient voice’ can be heard more loudly?

    I know government policies around the concepts of ‘self-care’ ‘patient-centred care’ and ‘patient involvement’ suggests that patients and their families should also take on some more responsibilities in tackling these issues. Some of these responsibilities may include patients being more ‘proactive’ in scheduling their medication reviews rather than wait to be contacted by the GP. What are thoughts about this?

    Irene, I think the issues of how patients may sometimes think that replacement/substitute medications work or don’t work may be down to how the change is communicated during dispensing. What do you think and have had an experience of this?

    Thanks both.

    Irene Soulsby
    27th July 2017

    I have heard in the past that people say that they don't like the replacement but others say that the replacement is better! I have noticed that my meds are sometimes by different manufacturers (you can tell by packet etc) but I haven't noticed any difference in effectiveness

  • Violet  Rook
    24th July 2017

    I think medicines should be explained to patients. It is important to know what they are and what they do,also their side effects. Giving patients the respect of providing information about their medicines should be vital and is good for psychological health.

    Beth  Jacobson
    25th July 2017

    I wonder how many people are on medications that are simply prescribed to counteract the side effects of something else they're taking?

    Dapo Ogunbayo
    26th July 2017

    Thanks Violet and Beth for your comments. Communication of medicines information between healthcare professionals (GPs, pharmacists) and patients is known to be sometimes problematic.

    Research has shown that often times, there are differences in how healthcare professionals and patients prioritize the type of medicines information that should be provided and there are a lot of factors responsible for this.

    I wondered whether you had any experience that you could share about the type of information that you received when you were prescribed and dispensed a new medicine?

    Beth, you right that some medicines are prescribed to counteract the side effects of something else, and this is quite common with some pain-killers that cause stomach discomforts. There are now renewed efforts to 'deprescribe' some of these medicines. Have you, or do you know of anyone that has had this type of discussion with a GP or pharmacist before? Thanks

  • Irene Soulsby
    24th July 2017

    Perhaps another complication Is the appointments. We have a practice of several doctors. I think everyone has their favourite doctor and it can be difficult to get an appointment. People have said in the past that there is only enough time to discuss one or two things, any more and you have to make another appointment. If you end up seeing several doctors because your illness/concern is lasting awhile, is something lost in not seeing the same doctor for appointments?

    Ian Fairclough
    24th July 2017

    I agree with Irene on this point. Sometimes, but rarely, you can get a "double appointment," this gives you the chance to discuss your problems in some detail - I believe the average appointment time is 10 minutes, which for an elderly patient is not always enough time to discuss one condition never mind multiple conditions.

    Dapo Ogunbayo
    26th July 2017

    You have both raised valid points about appointments. Do you have any suggestions about how these could be addressed?

    Irene Soulsby
    27th July 2017

    It's very difficult, I think also the doctor might have to leave if there's an emergency and also appointments can run behind if some appointments take longer than others. Perhaps are they limited to time because of targets that they have to meet?

    Dapo Ogunbayo
    27th July 2017

    I think appointment times are affected by a combination of factors that include NHS/GP targets, fewer GP/healthcare staff, increasing number of patients, etc.

    And you are right about appointments running behind if some appointments take longer than others. Appointment/waiting times are sometimes used as a quality indicator of how GPs are performing.

    Some solutions that have been considered and trialled include using the expertise of other healthcare professionals (pharmacists, nurses, healthcare assistants), telephone appointments, video/tele-health appointments, etc.

    In relation to providing more support with medicines, which of these solutions would you prefer and why? Are there any other ways that you think issues with medicines can be discussed and resolved without seeing a GP?

    Irene Soulsby
    27th July 2017

    My usual first port of call is the pharmacist (but then common ailments that I think are nothing serious) I know that our Practice gets busy and I am quite happy with a phone call. Possibly if I am a bit worried, I would like one face to face. I know that our Practice now has appointments on the day and you can book online which is much better for me. We also have 24 hr telephone booking system (I've not used yet but it was very handy when I rang to cancel something)

  • Irene Soulsby
    24th July 2017

    I had a friend who appeared (from conversations) to be on quite a few tablets. However, she seemed to think that she was ok and stopped taking certain ones. This seemed to cause problems in that she would feel terrible when she stopped them. I did worry about her in that she seemed to go to the doctor, get a prescription and then not take meds. She was on such a concoction at the end, I think they were trying to start again from scratch. I think also this is a problem, some people get a prescription, collect it and then don't take them or not finish the course.

    Bianca Tobin
    24th July 2017

    Indeed, when on regular medication a repeat prescription service may save on appointment times, however from personal observation this leads to many costly medications going to waste and costing the NHS millions because the medications are stockpiled and often expire before being used. I think a new system could be that repeat prescriptions require review and renewal every three months.This would prevent massive costly wastage of medications.

    Dapo Ogunbayo
    26th July 2017

    Hi Irene, Ian previously mentioned about ‘experimenting’ with his meds and then ‘confessing’ to the doctor about this later when necessary. This is an area that may be out of control of doctors and pharmacists as it is impossible for them to know what patients do with their medicines once they are at home.

    It is known that patients that stop taking their medicines do so for reasons which are, many times, well-rationalised.

    It is however always advisable to discuss these concerns and ‘experiments’ with the doctor or pharmacist, as some medicines could be potentially harmful if they are stopped abruptly.

    Have you had any further discussion with you friend on what she’s been doing with her medicines? Thanks

    Irene Soulsby
    27th July 2017

    Sadly, her health seemed to be declining and she became prone to falls, had a fall and ended up in hospital but never recovered and passed away a couple of years ago. She became very anxious when she was older and I used to say that I would go with her to doctors and hospital appointments if she needed someone to come along. Is this quite common as age progresses?

  • sandy harvey
    24th July 2017

    I have a very specific point....

    Certain drugs and treatments need very specific timing in when they are taken. For eg, Parkinson's Disease requires medication at exact times throughout the day. This is a real issue even though a single tablet missed can cause major mobility issues for example.

    Various ways that mulitple meds are given - and in particular the medipacks - do not allow for these points and therefore end up being quite complicated.

    Dapo Ogunbayo
    26th July 2017

    Hi Sandy, you absolutely correct that some drugs need to be taken as consistently as possible to maintain the optimal blood levels.

    And I also agree that the ways some medicines are packaged and supplied can complicate this.

    Have you, or do you know anyone that has had any of these issues and can you share how this was dealt with? Thanks

  • Dapo Ogunbayo
    18th July 2017

    Thank you very much for all your contributions so far, and for sharing your experiences on this topic.

     

    I will be commenting/replying all your posts when the discussion goes 'live' next week (24th - 28th July). However, please feel free to continue to make your contributions before then.

     

    So far from the discussions, it seems the issues related to medications can be categorized under 4 broad topic areas;

    1). The number of multiple medications taken everyday

    2). Medications packaging from manufacturers and from the pharmacy

    3). Communication about medications (with doctors and other practitioners)

    4). Information and directions when taking multiple medications

     

    Please feel free to keep your contributions coming and add to the above list if necessary. Thank you!

  • Robert Davidson
    18th July 2017

    I cannot disagree with anything that has been written below.

    Aged 86 I am lucky in only needing medication for two problems - high blood pressure and a minor prostate inconvenience.

    I hate getting a pack of 30 and a pack of 26. Why not 2 packs of 28???

    As Irene has said - "before food, with food, after food, morning, evening"

    Does it make any difference?

    Dapo Ogunbayo
    24th July 2017

    Hi Robert, yes, it could make a difference depending on the type of medicine or other factors. In general, advice about when to take medicines often makes a difference in terms of maximising how the drug works (e.g. to improve absorption) and/or in reducing any potential side effects (e.g. some painkillers should not be taken on empty stomach).

    Have you previously been offered any advice with regards to when/how best to take your medicines by the pharmacist or doctor?

    Happy to hear other people’s experiences about whether they receiving solicited and/or unsolicited advice when they receive their medicines from the chemist/pharmacy.

    Robert Davidson
    24th July 2017

    I have not seen a GP for several years. MOT at surgery once a year (by a Health Care Assistant). See Urologist at Hospital once a year. I have never been given advice on when/how to take my medication.

    I should really read the leaflets>

    Having read the leaflets, I am totally confused.

    I take 3 tablets for high blood pressure. One leaflet says before or with breakfast, the second says with breakfast and the third says take before bedtime. HELP.

    Dapo Ogunbayo
    26th July 2017

    Hi Robert, sorry if I'm not very helpful with this. I can understand the inconvenience of having to take different medicines at different times when it could be easy to take it all at the same time. I would suggest to speak with your pharmacist or GP to clear any confusion. There might be alternatives that they could recommend which would be more convenient. You could also see to discuss a medication review - the pharmacists could offer you one without having to book an appointment

  • Irene Soulsby
    17th July 2017

    It sounds a very interesting and worthwhile project. Personally, I take 2 meds once a day which isn't bad but I know that some people take a considerable amount of tablets daily, I don't know how they cope. I have spoken in the past to my doctor about reducing my medication, which I did (sometimes high doses cause problems sometime later) and I do wonder if when you are on several tablets, this means they don't work together and cause further complications. Apart from before food/with food/after food! I also agree with the comment that foil packs/childproof bottles can be very awkward!

    Dapo Ogunbayo
    24th July 2017

    Hi Irene, thanks for your contribution. Many prescribing strategies now aim to ‘optimise’ medicines to a point where patients take the minimum number of tablets/medicines at the lowest possible doses to produce the highest possible health (and cost) benefits! Achieving this balance is tricky and a challenge for many clinicians, and is an ongoing area of research.

    There is now an interest in ‘actively involving’ patients in decision-making during prescribing, rather than deferring to the doctor alone in making a clinical judgement. What led you to decide to speak with your doctor about reducing your medication? Did you experience any problems or did you read something about the medication?

    With regards to the packaging of medicines, as I mentioned in my response to Christa’s contribution, could it be down to how the information is being communicated when the medicines are being dispensed? Would also be keen to hear your thoughts on how you have managed to cope or get around any specific issues that you have experienced with the medicines packaging.

    Irene Soulsby
    24th July 2017

    I was having problems swallowing and went to see one of my practice doctors. (I know swallowing problems need checking out but am still nervous about appointments!). By the time the interview was over, I had a hospital appointment for a few days later! (I did mention to the doctor that I had cancer treatment in the past). The hospital check involved me taking a course of tablets (I'm not sure if it was mentioned that I would have to contact my doctor for a review - I think it was) However, after taking the tablets for (a month?) they ran out and I was attempting to make another appointment with my doctor to see what happened next. I was more aware of my old symptoms and what had been causing them. I felt something was not quite right and had to go to Boots to ask if I could get something that they sold, mentioning that I had a doctor’s appointment in a few days’ time (I was feeling very uncomfortable with swallowing by now. When I saw the doctor (not sure if it was in person or phone call) she mentioned that this particular tablet wasn't good for bone health so it was decided to halve my dose, mutual decision. This seemed to go ok and I had a further appointment in which I said I would reduce again. This seemed to go well and I thought I might get away with an occasional tablet. This did not work and so I ended on my lower dose (ie from 40mg to 20mg and then to 10mg) I think it is very useful to have a conversation to see if you can meet half-way.

    Irene Soulsby
    24th July 2017

    I didn't used to read the information that came with medicines but I do now. Often we get medicines and don't know what they are doing, what we are taking them for. I am more aware of side effects now!

  • David Stewart-David
    16th July 2017

    I take Warfarin, Bisorolol, and Simvastatin, and have done for 6 years, following a TIA and diagnosis of atrial fibrilation. I have had two problems with this medication - one acute, and one a mild inconvenience. The acute problem was that the hospital registrar who originally prescribed Warfarin intended to write that I should take aspirin until Warfarin was available. I took both for some weeks until I had a violent attack of vomiting ("coffee grain") and diarrhoea, which led to my being taken to hospital where the wrong prescriptive advise was noted. I was an in patient for 7 days. The inconvenience is that of having to reorder Warfarin from the GP, as opposed to the routine repeat prescriptions of the other drugs. I take all these pills (four per day) at night. I have to have an INR test about once every six weeks. The packs of Bisoprolol are very inconvenient to open, but I'm glad to be alive.

    Dapo Ogunbayo
    24th July 2017

    Hi David, thanks for sharing this. Research has shown that a sizeable number of hospital admissions are often linked to medicines-related problems such as drug interactions that could be prevented via some simple interventions to minimise these errors during prescribing and dispensing of medicines.

    As Ian mentioned, no man is perfect and mistakes do happen, but there are checks that could be put in place. From your experience, what do you think could be put in place from a patients’ perspective to minimise this from happening?

    Also with regards to the two inconveniences that you mentioned, can you share the ways that you’ve tried to resolve them and the results of these? Thank you

  • Christa Lloyd
    14th July 2017

    I have to use a range of medication and what bugs me are many issues - in no particular order here are a few that leap to mind

    the stupidity of the foil packs medications are supplied in- When will manufacturers get together with GPs to have the correct number of pills in a pack that match prescribing numbers - I get fed up with cut up packs in a box. Manufactures are also using too many air pockets - when I try to open these the pills go flying some never to be seen again

    Pharmacists are never helpful when it comes to dispensing brands that provide good accessible packaging I get fed up of being told these brands are not stocked by the company

    As for childproof bottles these should be re-branded patient proof bottles - and pharmacies never have normal bottles in stock - nor the time to move the medication from one bottle to another - yet tell me I shouldn't do this myself as medication must be kept in the container it is supplied in.....

    Dapo Ogunbayo
    24th July 2017

    Hi Christa, the medicines packaging issues you have described are quite commonly reported and I struggle to understand why some of the many suggested solutions are not more widely implemented.

    Could it be down to how the information is being communicated when the medicines are being dispensed?

    Can you share your thoughts on how you have managed to cope or get around some of the specific issues that you have experienced?

    Christa Lloyd
    25th July 2017

    I find getting into a routine helps with the before and after food medications so I take blood pressure meds, cancer hormone meds, stomach settlers and paracetamol on waking up. I then take the slow release anti inflamatory after breakfast and then painkillers throughout the day according to what I am doing.

    I put out a week at a time in the pillbox stack Lidl's supplies ignoring the times of day printed on them. this is where I sit with a craft knife, pair of scissors and a dark coloured towel on the bed to open the different foil packages one at a time with the open pill stacking boxes laid out. The dark coloured towel helps me spot any medications that jump from the packs as my medications are all best visible against a dark background.

    I have changed pharmacy many times when I encounter problems with staff telling me what they can't do rather then helping me find a solution.

    There is a pharmacist linked into our GP practice who I saw for the first time a month ago and she has said said she will stipulate the brand on the repeat prescription for the tablets I take to reduce my blood pressure - so this may stop me having to reject the brand with the big air pockets when they have been dispensed. I had overcome this problem for over a year until Lloyds took over Sainsbury's pharmacies and re- introduced the problem! I will see if this works but have already told them that if they can't put a note on their computer to make sure I can get a medication I can take I will be looking around again for a different pharmacy who will stock the brand I can get into easily not the one where the tablets go flying. Not that this has made any difference in the past....for a while they tell you they will get the right brand in but I get fed up of having to make multiple visits to get my medication.....at least at Sainsbury's I can get other shopping whilst there and they have convenient disabled parking.

    Irene Soulsby
    25th July 2017

    Yes, some of the foil packs are horrendous to get into! I take two different tablets a day - one comes in a pack of 30 and the other 28) Both are ordered at once (I started taking them at different times) so I end up with a month's supply of one and I have hardly any left of the other one (which makes it tricky to have automatic order on 2 monthly basis) Two missing a month adds up after awhile. One strip has 7 tablets (handy) and the other one has 10 so for the one that has 10 tablets in, I use one strip for Mon-Fri and a separate strip for Sat and Sun (which works well, but if I get a substitute design, this thwarts my nice system!)

  • Ian Fairclough
    14th July 2017

    My mother, before she died, was taking 12 different medicines per day. She took some medicines to help with her various illnesses & other medicines to counteract the side-effects of the these medicines.

    After a stay in hospital, or seeing a different GP, her medicines would be changed. This caused confusion for me & the pharmacist, which then lead to more visits to her regular GP to return her medication to some normality. She was in her nineties and was taking medication to stay alive, not cure her condition.

     

    I, as a 75 year old, take six different medicines per day for the same reasons - to stay alive and generally be "pain free" - not to cure any ailment.

    I felt that 12 per day was too many for my mother & I think that my 6 per day - which includes two pain killers - is about the limit. But as non-medical person I can't judge without chatting with my GP.

     

    I sometimes experiment with reducing my medication because I wonder "is it really necessary to take so many." I sometimes chat with the Practice Nurse and every six months I have a discussion with my "named" GP about my medication but I have to go by the advice given.

     

    I don't need or want any support about medicines except for that as indicated above. I would not take any herbal remedies as I would have concerns about any conflict with my prescribed medicines. I always read the manufacturers leaflet which comes with the medication "just in case", because no man is perfect - lol - GPs know a lot, but they don't know everything.

     

    Dapo Ogunbayo
    24th July 2017

    Many thanks Ian for sharing your experience here. GPs and other clinicians often use evidence-based prescribing guidelines that help them in deciding when to initiate and prescribe medicines, but there are few guidelines on when to stop or ‘deprescribe’ medicines.

    This means that some people might be taking some medicines beyond the point when they actual benefit from them. This may lead to the inconvenience of taking many medicines every day which could become potentially harmful. Discussions about these should ideally be taking place during routine health checks/reviews at the GP and/or pharmacy.

    I wondered what your experiences are of the nature of the discussions you’ve had during these reviews for yourself and/or your mother?

    Also interesting that you said you “sometimes experiment with reducing medication…” What do you take into consideration when you decide to experiment? Do you discuss these with your GP, other health practitioner (e.g. pharmacist) or consult other sources of information?

    Dapo Ogunbayo
    24th July 2017

    It would be interesting to hear from others who may have similar or different experiences

    Ian Fairclough
    24th July 2017

    Hello - A routine health check with my GP takes place once every six months - I can see a Practice Nurse as many times as I wish.

    If the condition I am taking the medication for eases/changes or goes away I will use my own judgement without consulting/informing the doctor and reduce the intake of that medication - I analyse my own health - I experiment with the prescribed medication.

    If my experimenting works I tell the GP on my next visit - If it doesn't work then I make an early appointment and "confess my sins."

    If any changes that occur are affecting me in a negative way I will stop taking the medication and see a GP as soon as practicable.

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