91ÊÓƵ

As a pharmacist-health services researcher, Dr. Antoinette Coe studies how to improve medication use and safety. Some of her motivation comes from personal experiences as a caregiver and helping family members keep track of their medications – which can get complicated.

Research suggests that half of medications prescribed for people with chronic diseases might not be taken correctly.

Coe, an assistant professor of clinical pharmacy at the University of Michigan in Ann Arbor, answered questions about how to prevent errors for "The Experts Say," the 91ÊÓƵ News series that asks specialists to explain how they apply what they've learned to their own lives. Her remarks have been edited.

What are some of the most frequent errors people make with their medications?

Some common problems people make are related to how they take their medication, such as forgetting to take it or not taking it at the right time; taking too much or too little; and taking medications that can interact with each other, including over-the-counter medications, herbal products and supplements.

How can medication problems arise?

Often, communication plays a large role. For instance, when a health care professional counsels the patient on how to take their new medication in a way that is not clear, the patient may not understand the directions.

What are the concerns for older people?

Older adults are at higher risk for medication problems. They may have multiple chronic conditions, which can lead to complex medication regimens, leading to an increased risk for drug interactions or challenges with medication adherence.

Also, older adults may have changes in liver or kidney function, which can affect how the body metabolizes and clears the medications from the body.

Vision or hearing impairments may lead to problems reading prescription labels or hearing instructions. Arthritis may make it hard to open bottles. Cognitive decline may make it harder for older adults to remember how or when to take their medications. Medication costs may also be a large problem.

Are heart medications a particular concern?

Heart medications can be a source of medication-related problems, especially since cardiovascular conditions are so prevalent, particularly among older adults who are on multiple medications. The medications may have side effects such as dizziness or fatigue or need dosage adjustments requiring monitoring and communication with their health care team.

What sorts of questions should people ask about their medications, and whom should they ask?

A patient should understand what each medication treats and how and when to take it, including whether to take it with food.

Some questions to consider for their doctor:

– What is this medication being prescribed for?

– What are potential side effects, and what should I do if they occur?

– How long do I need to take this medication?

– Is there anything I should avoid while taking this medication, such as food?

For their pharmacist, they can ask:

– How should I take this medication?

– Does this medication interact with any of my other medications?

– Are there any side effects I should be concerned about?

– What should I do if I miss a dose?

– Where should I store this medication: in the refrigerator or at room temperature?

What should people and their caregivers do to avoid medication errors?

One of the most important things is for people to have an accurate and up-to-date list of all medications they take, including prescription medications, over-the-counter medicines, herbal medications and supplements, and share it with their health care team.

Another helpful thing is to fill all their medications at one pharmacy, if possible, so the pharmacist knows their medications and can check for drug interactions or duplications.

People should ask their pharmacist, doctor or other health care team member if any medication instructions are not clear.

Storing medications properly and keeping them out of reach of children is also important.

What advice do you give to friends or family when asked to help sort out medication problems?

My advice is to make sure they have a list of all of their medications, dosages, how to take them, why they are taking them, and who prescribed their medication. They should keep that list with them, such as in their wallet, to bring to all of their medical appointments.

And if they are having any issues with remembering to take their medications as prescribed, I suggest they consider using a medication pill box, a reminder alarm or an app on their phone.