The Medication List: Another Vital Sign
Knowing what meds you take and why are steps toward health
As a pharmacist, I'm frequently impressed by how well some people do in managing their complicated medication regimens. The truth is that taking medicines appropriately is not easy, and having more medicines to take doesn't make it any easier. But medicines can be truly lifesaving. So how do we work with people to balance the importance of medications with the knowledge that too many medicines can make it difficult for them to take their therapies correctly?
One thing I've been teaching my students and residents—and discussing more with my patients—is to think about the medication list as one of the "vital signs" of health, along with key indicators including blood pressure, heart rate, and body temperature. Having an accurate medication list—as well as knowing what each medication is for—is another vital sign of health.
When I ask patients with diabetes if they have a history of high blood pressure, they can almost always tell me yes or no. It is similar when I ask about high cholesterol or having had a heart attack. But when I ask which medications they take to help manage their conditions, I don't always get a reliable answer. Some patients say it's in their chart. Other patients know things by color—a "blue capsule, two white tablets, and some other pink and red things." But other patients can tell me exactly what they are taking and why, and that is always better for both me and them.
Admittedly, the health care system bears some blame here. The numbers can become daunting. I have seen patients with over 20 active prescriptions who say that it is a full-time job to keep track. Who can blame them for feeling a little overwhelmed? I saw a patient in the hospital last week who was prescribed 12 medications and had been admitted for a complication caused by not taking one of them. He told us that he was willing to take "up to five medications" per day. I told him that we appreciated his honesty and that it was better for us to know that rather than have him decide at home which ones he would take and which he would skip.
The truth is that we all are our own pharmacists. We have to decide each day what medications to take. The doctors, nurses, and pharmacists around us are there to help each of us be the best pharmacist that we can be. No one should be afraid to tell their pharmacist or doctor that they feel overwhelmed by their prescriptions or that they are having difficulty with one or two of them in particular. After all, each one of us is in charge of a personal medication list, and it truly is a vital sign of health.