Managing Several Medicines: Simple Habits and Help Between Visits

Liam: That agency says that each year in the United States, these events cause more than one and a half million visits to hospital emergency departments.

Claire: One and a half million. Just from medicines.

Claire: Thanks for joining us. You're listening to Between Visits, sponsored by Hope Health Network, a network of medical practices serving South Carolina. We dig into the medical and mental health topics that matter most to patients and the public.

Claire: I'm Claire, and this is episode 11. I'm going to quickly play our disclaimers, and then we'll get started!

Recorded disclaimer: This show is for entertainment, education and general information only. It's not medical advice, and listening doesn't make you a patient. Our hosts and guests are not real people, medical doctors or healthcare providers. We do our best, but we can be wrong, and our content can have errors and omissions. Talk with a licensed medical provider in your state before you make any decisions about your health or medical care.

Claire: In an emergency, call 911. In a crisis, call or text 988.

Claire: Joining me today is Liam, from our digital entertainment team. Welcome, Liam!

Liam: Happy to be here, Claire. Is that a new coffee mug?

Claire: It is. It holds about twice what the old one did.

Liam: So that's the secret to all this energy.

Claire: Today we're talking about Managing Several Medicines: Simple Habits and Help Between Visits. Well, we're excited to get your thoughts on this important topic, Liam.

Claire: Let's dig into taking a lot of medicines. One from this provider, two from that one, and then a vitamin on top. It adds up fast.

Liam: It does. If you live with two or more long-term conditions, you may take several medicines every day, often from more than one provider. Keeping them straight takes real work.

Claire: So if someone's feeling a little overwhelmed by it, that's not just them.

Liam: Not at all. And there are simple habits that help, plus help you can get between visits.

Claire: Okay. But first, why does it matter? If each medicine is fine by itself, what's the problem with taking several?

Liam: MedlinePlus, from the National Library of Medicine, explains it. When you take several medicines, you may be more likely to have side effects. And you are at higher risk for drug interactions. The provider who prescribes a medicine and your pharmacist should go over this with you before you start it. So ask them any questions you have.

Claire: Drug interactions. What does that mean in regular words?

Liam: It means one thing changes how a medicine acts in your body. That can happen between medicines. It can also happen with alcohol and some foods. Some interactions can be serious.

Claire: Food too? So it's not only what's in the pill bottles.

Liam: Right. That's why it helps to ask about them.

Claire: What else makes it harder?

Liam: It can be harder to keep track of when to take each one. And you may end up taking a medicine you no longer need, especially when several providers prescribe for you.

Claire: Oh, I can see that. One provider starts something, and nobody ever comes back and asks if you still need it.

Liam: It can happen. That's why reviewing your medicines matters.

Claire: Does age play a part in this? I feel like things hit me differently than they used to.

Liam: Age matters too. MedlinePlus explains that as you age, your body processes medicines differently. For example, if your kidneys work less well, a medicine can stay in your body longer.

Claire: So the same pill can act differently when I'm older than it did when I was younger?

Liam: Your body can handle it differently, yes. That's one reason a dose may need a fresh look. Ask your provider.

Claire: How big a deal is this, really? Do people actually get hurt, or is this just being careful?

Liam: The Centers for Disease Control and Prevention has a term for it. An adverse drug event. That's when a medication causes harm to someone. It includes side effects, allergic reactions and medication errors.

Claire: And how often does that happen?

Liam: That agency says that each year in the United States, these events cause more than one and a half million visits to hospital emergency departments.

Claire: One and a half million. Just from medicines.

Liam: That's what the agency reports. Medicines do a lot of good. They can also cause harm, so it's worth taking a little extra care.

Claire: All right. So what do we do about it? Give me the habits. Start with the first thing.

Liam: Keep one up-to-date list of everything you take. Prescription medicines. Over-the-counter medicines, which are the ones you buy without a prescription. Vitamins, supplements and herbal products.

Claire: So a shoebox full of pill bottles doesn't count as a list.

Liam: The shoebox can stay. But yes, write it all down in one place.

Claire: Wait, even vitamins? I wouldn't think to mention a vitamin. It's just a vitamin.

Liam: Even vitamins. They belong on the list too. Your provider can't check what they can't see.

Claire: Fair enough. And where do I keep this list?

Liam: The U.S. Food and Drug Administration suggests keeping one copy at home and another with you. That could be in your wallet, your purse or your phone.

Claire: That's easy. Okay, I have my list. Now what do I do with it?

Liam: Review it with your providers and your pharmacist at each appointment. Ask whether you still need each medicine, and whether any dose should change.

Claire: So it's okay to just come out and ask, do I still need this one?

Liam: Yes. It's a good question to ask. And when a new medicine is added, ask whether it could interact with what you already take.

Claire: Now here's one I bet a lot of people do. You feel better, so you quit taking it. Or it makes you feel funny, so you skip a day. Is that so bad?

Liam: Take your medicines as directed. Do not skip doses or stop a medicine on your own. Talk with your provider first. They can tell you whether you still need it or whether the dose should change. And in an emergency, call 911.

Claire: So tell them, don't just quit.

Liam: Exactly.

Claire: And what about remembering? I walk into a room and forget why I went in there. Remembering all those medicines is a lot.

Liam: A few simple tools can help you stay on schedule. A pill organizer, a timer or a reminder app. MedlinePlus and the Centers for Disease Control and Prevention both suggest tools like these.

Claire: Those are pretty simple. Anything else on the list?

Liam: One more. Keep up with any blood tests your provider recommends.

Claire: That's a lot to keep up with on your own, even with a list. Is there any help for this between visits?

Liam: There is a service called Chronic Care Management. You may hear it called C C M. It's a Medicare service for people with two or more serious chronic conditions. Chronic means long-lasting. These are conditions expected to last at least a year.

Claire: What kinds of conditions?

Liam: Medicare gives arthritis and diabetes as examples. Your provider decides with you whether this service is right for you.

Claire: And how does it help with my medicines?

Liam: Under Medicare's rules, it includes a comprehensive care plan. That's a plan that lists your health problems and goals, your other providers and your medicines. It also includes a review of your medicines and how you take them.

Claire: How I take them. So not just what's on the list, but what I really do at home.

Liam: Right. It also includes support when you move from one care setting to another, such as after a hospital stay. That's often when medicines change.

Claire: And who's actually doing all this? Who do I talk to?

Liam: At Hope Integrative Medicine, a member of Hope Health Network, your care coordinators work closely with your provider between visits. They keep your care plan, including your medicine list, up to date. They also keep your full care team informed, at Hope and among your outside specialists.

Claire: So my specialist and my regular office can both know what's going on.

Liam: That's the goal. And you can reach your care coordination team with questions, including through secure text messages. Hope Integrative Medicine is not an emergency service, though. In an emergency, call 911.

Claire: Okay, the money question. What does that cost me?

Liam: Medicare Part B may pay for this service if you are eligible. After the Part B deductible, you generally pay 20 percent of the Medicare-approved amount.

Claire: And the deductible is the part you pay first, before the plan starts paying.

Liam: Right. Medicare Advantage plans must cover everything Original Medicare covers, but costs and rules vary. Coverage rules can change too, so check with your plan for your own costs.

Claire: And I'd have to agree to it? Nobody just signs me up?

Liam: Right. It starts only with your consent, which means your okay. And you can stop at any time.

Claire: If someone's listening and they want to bring this up at their next visit, what could they say?

Liam: Here's a simple one. Could we go through my medicine list together, and would Chronic Care Management help me keep it up to date between visits?

Claire: I like that. It gets two things done with one question.

Liam: It does. And you can bring your list with you when you ask.

Claire: Okay, before we wrap up. If people only remember a few things from today, what should they be?

Liam: First, keep one list of everything you take, even vitamins and supplements. Then go over it at every visit.

Claire: Okay. Shoebox stays, list goes in the wallet. What else?

Liam: Second, don't skip doses or stop a medicine on your own. Talk with your provider first.

Claire: And one more?

Liam: You don't have to keep track of it all by yourself. Your provider and pharmacist can review your list with you, and you can ask whether Chronic Care Management is right for you.

Claire: That's really helpful. Thank you for walking us through this.

Liam: Thanks for having me, Claire. I hope it helps someone.

Claire: This episode is sponsored by Hope Health Network. Its member practices all have providers experienced in managing multiple medicines, or can refer you to a network provider who is. Hope Health Network medical practices provide evidence-based medical care and include Hope Integrative Medicine, Hope Medical Associates, Hope Behavioral Medicine and Hope Addiction Medicine. To learn more, go to Hope Health Network dot com. That website, along with appointment links for all four practices, is in the description of this episode.

Claire: One last reminder. In an emergency, call 911. In a crisis, call or text 988.

Claire: This podcast is a production of Hope Health Network Media.

Claire: You've been listening to episode 11 of Between Visits, Managing Several Medicines: Simple Habits and Help Between Visits. Thanks for hanging out with us. See you next time!