Miller: Not keeping up with prescriptions can get patients 'into a bind'

By By Warren Arceneaux / American Press

Keeping on schedule with prescribed

medicine can be a chore for people on numerous medications, but is also

crucial in maintaining

health and safety.

Patients will sometimes stop taking medication if they are not feeling symptoms of illness, leading to serious health problems,

said Dr. Dennis Miller, family physician at Lake Area Medical Center.

“That is one of the major things that will get people in trouble. They will be on medications that are designed for daily

use, and they will just take them as they feel are needed,” he said.

“You can get in a serious bind. I have

known some healthy people in their 30s die from bad asthma flare-ups.

High blood pressure,

depression, diabetes, asthma or COPD are major areas where missing

a dose or two can get you into a bind quick.”

Miller said a crucial step in avoiding such issues is making sure patients understand why they are being given a prescription

and what the medicine is intended to do.

“Health care providers need to do more as a group about educating our patients,” he said.

“I spend extra time with patients

talking about medications. It is not like, ‘Here, take this for your

high blood pressure.’

I am giving you this medicine that will keep your pressure under

control. It will be normal while you are taking it. If you

stop, it will go up. Same thing with any medication. I will spend a

few minutes to empower them, to make them a part of their

own health care. It is teamwork; they have to be a part of the

health care team. They are a critical part of it.”

Another problem in having people stay on a proper dosage schedule is a patient not recalling whether he or she has taken the

prescribed dosage.

“One of the big problems in the senior population is memory,” Miller said. “They might not remember taking it and take a double

dose. People double up on their blood pressure medicine, their pressure plummets and they are in a bind. They might end up

in an emergency room. Another problem is that a lot of people are on a lot of medication, so it is really a task for them

to keep up with what they are on, why they are taking it and if they are taking it properly.”

Pillboxes are a tool people can use to stay on schedule.

“They are fantastic, and they are coming up with more options,” Miller said. “On the higher end, there are (automated) Pyxis

machines that will dispense only the proper amount. By and large, pill containers are very good.”

A tougher problem to solve is people who choose not to take medicine as advised.

“It goes with education: Here is why you are taking this medication, and this is why you need to take on a daily basis,” Miller


“A lot of times it is a historical thing. You remind them that they were in the hospital because of really bad heart failure;

that is why it is important to take this every day. Ask what are their concerns about taking this every day, what barriers

are there and what can we do to fix those.”

Miller said he tries to keep prescriptions to a minimum to help patients.

“I am not a big pill pusher,” he said.

“If it is required, great, I will prescribe it. One of my big goals with

any patient,

particularly the senior population, is what we can do to make

their life more simple, their health safer and their pocketbook


Trouble paying for medications can lead patients not to take medicine as prescribed, such as cutting pills in half and taking

only half the prescribed dosage to delay refills. Miller said generic medications can help cut costs.

“Probably 95 percent of what I write is

generic,” he said. “They can speak with their physician. A lot of these


have drug assistance programs. Patients can shop around at

different pharmacies to get the best price or you can get a 90-day


Miller said waiting until symptoms of illness arise can produce dire consequences.

“A lot of times, once you start feeling symptoms, it is too late,” he said.

“High blood pressure is a great

example. It is called ‘the silent killer’ for a reason. It gets

horrifically high before you

start feeling symptoms such as blurred vision, the headaches,

chest pressure. Oftentimes it is too late. They can have heart

attacks, strokes, diabetes also. You can live quite a while with

your sugars in the 200-300 range. You may only feel a little

thirsty or be going to the bathroom more often and may not realize

that it is has been that high for a long period of time.”

Caretakers can help patients manage medications by regularly checking prescriptions.

“Do med checks. Go in and fill up that pill container for the week and do a quick check,” Miller said.

“When was the last time each prescription was filled? Do a pill count — are there extra pills or are pills missing? Was a

prescription filled a week ago, but still 30 or 28 pills in the bottle? Are they taking a pill every day? Ask if they are

up on their medication or do they need help with something. Home health is a really good resource where it is an extension

of us. They can monitor weights, blood pressure readings, sugar levels. Once again, educate them on their medications and

be sure they are taking medications properly.”