As we age, many of us will accumulate various long-term or chronic illnesses, such as diabetes, cancer, and heart disease. In fact, by 65 years of age half the population live with two or more of these chronic conditions. Depending upon the type and severity of illness, it is likely that medicines – including those bought with prescription or over-the-counter - will play an important part of managing these conditions. This includes medicines used in the short term and for ongoing symptom management. Some may be prescribed “just in case” a symptom develops.
It is no wonder that older Australians find themselves taking a large number of medicines.
Carers often help the people they care for to manage medicines, especially for those with palliative care needs. Their involvement can be vital to enabling the person they care for to remain at home for as much as possible in the last months of life. Globally, researchers describe the difficulties carers’ experience. These include: mistaken ideas about pain and the role of analgesics, knowledge shortfalls, and lack of access to information and assistance.
So, how can the community pharmacist help?
Pharmacists do more than simply fill prescriptions. The following services may be useful to keep in mind.
Medicines List
The more medicines prescribed, the more challenging it becomes to remember all the information about them. A medicines list can be a valuable way to keep all the information about your medicines together.
A medicines list can be used to record:
- All the medicines prescribed, including prescription, non-prescription, over-the-counter, minerals, herbal and natural medicines;
- What each medicine is used for;
- How much of each medicine to use;
- When and how to use each medicine; and
- Known allergies to medicines.
It is important to keep a medicines list, particularly if many doctors are involved in your care. You should take it to each appointment and if any changes are made to your medicines, ask the doctor to update your medicines list in front of you. Importantly, medicines lists provide vital information about your medicines if you suddenly have to go to hospital or call an ambulance in an emergency. Often people are anxious at these times and it is difficult to accurately recall everything about the medicines you are taking.
Two ways that a medicines list can be managed are;
- Writing a paper medicines list and keeping it with you in your wallet or handbag; or
- Downloading the free NPS MedicineWise smartphone app, and using this to record your medicines. The app can be downloaded from Google Play or the App Store.
Medicine Reviews
Medicine-related problems are a major reason that many Australians go to hospital. Many of these hospital visits could be avoided. The Home Medicines Review (HMR) Program was developed in response to this: providing a proactive approach to managing medicines for people taking five medicines or more.
A HMR needs to be initiated by your GP, who recommends a pharmacist to conduct an interview with you. While this is preferably conducted at your home, sometimes a room at the GP practice can be used. During the interview, the pharmacist will:
- Record an up to date list of all the prescription medicines, over-the-counter medicines, vitamins and herbal products you are taking;
- Provide tips on how to use your medicines correctly, including ways to remember taking them;
- Check that prescription medicines, over-the-counter medicines, vitamins and herbal products are suitable to take together;
- Answer any questions you may have about your medicines.
At the end of the interview the pharmacist will note down recommendations for the GP. At your next follow-up appointment with your GP, they will discuss any recommendations with you, making any changes that you support.
The pharmacist’s review and report is paid for by the Australian government. The cost for the GP appointment will depend on whether your GP bulk-bills.
A MedsCheck is a simpler medicines review that is conducted free of charge by the pharmacist in the pharmacy. It does not require a referral from the GP and may also be helpful.
Medicine Organisers
For people that get confused or forget to take their medicines, a medicine organiser can help. This will assist you by separating your medicines into the times you need to take them. Medicine organisers make it simpler to: (1) remember to take your medicines, and (2) recall if you have already taken them.
There are two ways this can be done
- Purchasing a medicine organiser with separate compartments for the days of the week and/or times of the day that can hold your medicines, from the pharmacy.
- Ask the pharmacist if they offer a blister pack (e.g., Webster™ pak) service where a pharmacist prepares the pack weekly or fortnightly, for a fee.
Disposing of unused medicines
While it may appear extravagant to dispose of medicines that you’re no longer taking - holding onto them can be risky.
The Return Unwanted Medicines (RUM) project is a free Australia-wide service. It is as simple as returning out-of-date, unwanted and excess medicines to your usual pharmacy. The medicines are then collected and disposed of safely in high-temperature incinerators. This is much better for the environment and ensures that children and pets don’t have access to medicines that you no longer need.
Medicines help us to manage unpleasant symptoms. Using the services of a pharmacist, can be valuable in helping us to better manage our own (or someone else’s) medicines, to maximise their place in care.
Paul Tait, Lead Palliative Care Pharmacist, Southern Adelaide Palliative Services
If you could like to learn more about palliative medication visit the ‘Palliative Medication’ page on the CareSearch website.