Dr. Kevin Most: Drug Interactions
You may have seen the series of articles in the Tribune just before the holidays that highlighted the importance of drug interactions and the fact that often the patient is not notified of the possible drug interactions. The series highlighted that pharmacies did not do a drug interaction check prior to dispensing medications. Is this a big problem? You bet it is and it should get better one would hope.
Believe it or not 20 percent of Americans take 3 or more drugs and 10 percent take five or more. We also know that greater than 60 percent of Americans have more than one doctor they have seen and many over the age of 65 have greater than three different physicians. Let’s also not forget that urgent care or ER you may go to once for an acute problem. With this many Physicians in the mix, the number of different medical records, the number of pharmacies out there, is it a surprise that we have this concern.
Again, let’s put this in perspective, last year close to 4.5 Billion prescriptions were filled last year in the United States. That being said we need to be much better to make sure we are dispensing medications that actually help patients and not harm them. We need to use technology and time to discuss with patients what is actually happening with the medications they are taking.
So although the pharmacy companies were the highlight of the series the blame does not lie solely with them. Let’s be honest, we all own the safe care of a patient, primary care doctors, specialists, pharmacies and even the patient themselves.
The doctor prescribing the medications need to have a complete list of medications that the patient is taking. This can be difficult as often the patient presents to the office and does not have their complete list of medications. The doctors often don’t even know that a patient has seen another doc in some cases. Getting a complete and accurate list is sometimes difficult.
With many patients on high deductibles for medications, we are finding patients shopping around and looking for the best price. Patients switching pharmacies is not uncommon or using multiple pharmacies is common. With the large number of patients getting their medications thru mail order the problem is even bigger.
So what can we do, as a physician we need to be diligent in collecting up to date information on medications at each visit. We need to hold all physicians to the same standard, primary care and specialists.
As a patient we need to keep our own records handy. I recommend that you keep a list on your phone that is maintained by the patient. This allows for you to show each doctor which medications you are on and make for safer care. There are also great free apps that allow anyone to check and see if the medications you are taking have any interactions.
The last stop however needs to be the pharmacies as they are the last place before the drug being handed to the patient. The pharmacist as I have said many times are not just pull dispensers. They are very well educated experts in medications and medication safety. The majority of them actually have PhDs. We all may be frustrated at times waiting a few minutes in line at a pharmacy but think about your safety, is it worth 15 minutes. It is for me.