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Tuesday, September 30, 2014
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Miller: Not keeping up with prescriptions can get patients 'into a bind'

Last Modified: Wednesday, July 16, 2014 5:31 PM

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 said.

“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 heavier.”

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 companies have drug assistance programs. Patients can shop around at different pharmacies to get the best price or you can get a 90-day supply.”

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.”

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