In recent weeks I have looked at the safety of over the counter and prescription medication, particularly in relation to addiction. This week I wanted to focus on our responsibility when it comes to accepting a prescription and the use of the drugs provided. this is also an important issue when it comes to the elderly and keeping a record of their medical history and medications.
I am going to give you some overall figures for the UK it is likely that you will find similar statistics in whatever part of the world you live in. In effect this problem impacts the health and lives of billions around the globe.
After you have read the post you might like to take a peek in your medicine cabinet and review your own risk factors with regard to the pills you are taking!
Let me emphasise that on no account should you stop taking any prescribed medication without consulting your doctor. You were prescribed it for either an acute infection or chronic condition and it is important that you continue to follow the directions until safe to discontinue taking.
Discussions with your doctor or hospital.
What is important to remember, is that any communication or contact that you have with any health provider, should never be a one-sided interaction. With your health you need to be an active participant and a doctor can only prescribe medication based on accurate information that is either recorded in your existing health notes or what you tell them.
To put this into context let’s have a look at some of the figures for prescriptions in the UK.
Over 2.5 million prescriptions are written every day in the NHS with around 7000 medications prescribed in every average size hospital.
An error can occur at any part of the process – prescribing, transcription, dispensing, administration and monitoring.
The phase that is the most vulnerable to error is at the prescribing stage when incomplete medical histories and incorrect verbal information between patient and doctor takes place.
Prescription faults represent up to 11% of those that are dispensed at a cost of an estimated £400million per year.
Around 16% of those prescription faults result in harm to patients.That is around 45,000 people per day!
Most of these could have been avoided with complete medical records and accurate information taken at the time of prescription.
Issues that need to be taken into consideration and are missed due to lack of communication or incomplete records.
- Some drugs have severe side effects that can cause illness or disease either directly or as part of an interaction.
- Certain drugs can mask serious illnesses that go undiagnosed and treated.
- Lifestyle issues such as alcohol consumption, self-medication with over the counter drugs such as pain-killers. Smoking,recreational drugs or a poor diet that has resulted in nutritional deficiencies.Even regular use of herbal remedies can impact the effectiveness and more importantly the safety of the prescribed medication.
- If the patient is very elderly, dehydrated and malnourished, oral medication may not be as effective as the digestive system is not able to process in that form. The delivery system then is not effective and needs to be changed to intravenously into a vein or by sublingual administration beneath the tongue directly into the bloodstream.
How to become part of the solution rather than part of the problem.
Those of you who read my blog will know that I advocate individuals taking responsibility for their own health as far as it is possible. This includes following a healthy diet with at least 80% of foods being fresh and unprocessed to maintain a healthy immune system. Smoking, being very overweight and other activities that are harmful to your health are likely to result in the need for medical intervention at some point and certainly increases the requirement of prescribed medication.
As we get older our list of health issues throughout our lifetime gets longer.. and longer! You are also more likely to require a hospital visit and one of the most time consuming and probably inaccurate activities is the taking of a medical history on admission to the emergency room or a ward. This is particularly relevant when a patient is in extreme pain or with elderly admissions as I have experienced when accompanying my mother. Hence the following recommendation that I found saved a great deal of time and stress.
Whatever age you are. I suggest you compile an accurate medical history of your own that includes the following:
- Past illnesses from childhood including measles, mumps, German measles and chicken pox. Whilst some cause no further problems, chicken pox for example can lie dormant and result in shingles in later life.
- Drugs that have been prescribed in the past such as repeated antibiotics. This can cause an imbalance in the intestinal flora leading to a fungal overgrowth that impacts your immune system. Crohn’s disease, IBS and Gluten intolerance for example can inhibit the absorption of vital nutrients for your health and also medications.
- Current medications for any diagnosed long-term illnesses and keep copies of your current prescriptions with the list. Also the dosage – 50mls twice a day – one 575mg every 12 hours etc.
- Any herbal remedies that you are taking and for what reason.
- Any vitamin or mineral supplements. For example taking Vitamin K could affect your blood clotting and the effect of anti-coagulant drugs such as Warfarin.
- Any over the counter medications that you take regularly including pain killers.
- Any allergies that you have including to foods, insect bites, drugs such as Penicillin, Tetanus, Aspirin etc.
- Any past adverse effects from taking medication with a note of the specific drug.
- Details of your GP including address and telephone number
- Details of your next of kin and give two names with one as prime and one as secondary with a telephone number.
- Also note your weekly alcohol consumption (truthful) and if you smoke and how many a day.
- There are some key indicators for health that are worth having measured regularly including LDL levels of cholesterol, blood sugar levels and blood pressure. Make a note of your last numbers as these are very useful as a guideline. A doctor is likely to measure your BP but it is still useful to have a recent record to compare.
Even if a doctor insists on retaking your medical notes – you have this with you as an accurate reference. You should compile this for elderly parents and the other members of your immediate family. It will at the very least provide for a more detailed and therefore accurate record before diagnosis.
Rather than carry around the record in paper format for you and the rest of the family you might consider transferring to a small memory stick attached to your keys. This is very important if you are travelling abroad especially where language may be a barrier to accurate diagnosis so that your records are easily accessed and translated digitally. You can use a marker to put a large red cross on the cover.
At the doctors.
Unfortunately, appointments at the doctors in the UK are invariably restricted to 10 minutes and that is not much time to discuss the problem, make a diagnosis and then prescribe the correct medication. But you can take your own record so that it is easy to refer to when answering questions from the doctor. A paper copy can be kept with your medical records since the majority are still in that format and not digital or if possible your computerised records can be updated.
If you are then prescribed medication it is time to participate again by asking important questions. Here is a brief checklist that you can add to depending on your own health issues.
- What are the main causes of my condition?
- What does this drug do?
- Are there any changes I can make to diet or lifestyle that I could put in place immediately so that we can postpone this prescription?
- If I take this prescription now for the immediate problem what changes can I make so that I am only taking short-term?
- How often and when should I take the medication? (every 8 hours, after meals etc)
- Does it need to be kept in the fridge or any other specific storage instructions?
- What are the likely side-effects?
- Is there anything in my current prescribed or over the counter medications that this drug might interact with?
- What should I do if I begin to feel unwell after taking the drug?
- When do you want to see me again to monitor my progress?
You might like to visit the American Recall Centre for information regarding some specific drugs and medical appliances that may cause side-effects that can be serious. You will also find informative articles and news items on recently reported issues with prescribed medication.
Medication errors: the importance of an accurate drug history by Richard J Fitzgerald http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723207/
A bit about my nutritional background.
A little about me from a nutritional perspective. Although I write a lot of fiction, I actually wrote my first two books on health, the first one, Size Matters, a weight loss programme 20 years ago. I qualified as a nutritional therapist and practiced in Ireland and the UK as well as being a consultant for radio. My first centre was in Ireland, the Cronin Diet Advisory Centre and my second book, Just Food for Health was written as my client’s workbook. Here are my health books including a men’s health manual and my anti-aging book.
All available in Ebook from: http://www.amazon.com/Sally-Cronin/e/B0096REZM2
And Amazon UK: http://www.amazon.co.uk/Sally-Georgina-Cronin/e/B003B7O0T6
Comprehensive guide to the body, and the major organs and the nutrients needed to be healthy 360 pages, A4: http://www.moyhill.com/html/just_food_for_health.html
Thank you for dropping in and if you have any questions fire away.. If you would like to as a private question then my email is firstname.lastname@example.org. I am no longer in practice and only too pleased to help in any way I can. thanks Sally