MANAGING MEDICINE

Gertus Head of Scott City takes a variety of pills and isn't really sure what all of them are for.

"They just put them out and I start swallowing," he said.

Head is like a lot of senior citizens, who consume more than 30 percent of all prescription medicines and buy more than 40 percent of over-the-counter medications.

"Unfortunately the number of elderly patients taking medicines the way the doctor thinks they are is small," said Dr. Michael Wulfers, a family practice physician.

Sometimes patients think they can save money if they take a pill once a day instead of twice a day as prescribed. When a patient begins to feel better, medicines are often stopped even if there are pills left over. Another unwise practice is the sharing of medicines; just because they helped someone else doesn't mean they'll help you.

The first step toward proper medicine management is to talk to your primary physician and to let him or her know what medications you are taking. It's a good idea to take the pill bottles with you to the doctor's office.

"I would really like for patients to bring all medicines that are in the house," Wulfers said.

All medicines count, even antacids, laxatives, pain relievers, eye drops, dietary supplements and vitamins. For patients seeing more than one doctor, it's important that each one know what the other is prescribing.

Once all the medicines are laid out on the table, remembering which one is to be taken at what time and in what quantity can be a problem.

Wulfers recommends a weekly pill box to help keep meds straight. These boxes are divided into days of the week and have several sections per day. Family members or health care professionals can help with the weekly set-up of the pill boxes.

One of the jobs of Phyllis Lee, a registered nurse for Southeast Home Health, is to do just that for her patients, including Head. Home health care professionals visit their patients one or more times per week, depending upon the patient needs. Monitoring medications is much easier when a pill box is used.

"It's easy to see if the medicines haven't been taken," Lee said. This allows the caregiver to discuss with the patient the necessity of taking medicines properly and to contact the doctor if necessary.

Head is fortunate in that in addition to the visiting nurse, he also has an assistant from Walker and Associates Home Health of Bernie, Mo. Sandra Meador oversees Head's care Monday through Friday. Another caregiver is with him on the weekends.

"I begin the day by fixing him breakfast and putting his pills on the place mat," she said. "Before I leave for the day, I open the container and remind him to take his pills before he goes to bed."

"Not everyone will be able to have the services of a home health care professional," Wulfers said. "A family member can also set up a pill box and check on daily and weekly compliance."

It's also important for patients to become familiar with their medications and not rely on their shape or color alone when deciding what they are supposed to take. If a generic brand has been substituted for the regular medication, that little green pill may not be green any longer.

Another practice in the safe management of medications is to use the same pharmacy for all prescriptions and over-the-counter medicines.

Wulfers is a fan of the "family pharmacy" where the pharmacist actually gets to know the patients. Some insurance companies necessitate the purchase of medicines by mail, but the personal touch is lost in doing so, he said.

Staying with one pharmacy is also helpful for patients seeing more than one doctor. Computer programs alert the pharmacist when a patient is prescribed a medicine that may not react well with one already being taken.