(Sample) Chapter 60:

What can I do to improve my medication benefits?
In this chapter, we summarize our recommendations to you. They fall into eight broad categories.

  1. Prior to initiating treatment, you should know the intended use for the medication you are prescribed. In other words, what is the purpose or goal of the treatment? Also, is the medication intended for a limited time, or for life? If the treatment is short-term, you ought to know the factor(s) that will determine when to stop treatment. Is it the cure of an infection, symptomatic relief, or normalization of an abnormal laboratory measurement? It may be a good idea for you to record this information and save it for future reference.

  2. It is important that you understand and follow the prescription as given. This refers to the dose, the dosing interval, and the duration of treatment. Unless instructed by your physician, you should not take more or less of the medication. Dose adjustments should be made in consultation with your physician. The exception is if you experience a serious adverse effect (see Chapter 29). Try to follow the dosing schedule. In Chapter 44, we discuss how to handle a situation when you mistakenly skip a dose. Take your medication for the intended treatment duration. Feeling better should not be a signal to stop your medication, unless you have been instructed to do so. For some medications such as antibiotics, premature termination of treatment can have adverse health effects.

  3. Be aware of the potential risk of adverse effects. All medications cause undesired reactions in at least a subset of patients being treated. Pay attention to changes in your health status. Knowing what may happen makes you better prepared to deal with the adverse effects. In Chapters 3 and 4, we refer you to sources where you can learn more about your medications as well as your treatment options.

  4. If you are already prescribed other medications, it is important to determine how the new medication will act in combination with the others (see Chapter 37). Most of the time, this is not a problem. However, you may end up with a medication that is a duplication of what you are already taking. Additionally, a number of medications interact, which could weaken the beneficial effects or, worse, strengthen the adverse reactions (see Chapter 32).

  5. Don't overpay for your medications. Even if you have insurance coverage and only have to pay a nominal co-payment, there is no reason to waste money. Someone will pay the balance of the cost -- your health plan or the government -- and the cost will be reflected in your insurance premium or taxes. Consider the cost-saving recommendations in Chapters 20, 19, and 21. You can save money without sacrificing the quality of your care.

  6. Have realistic expectations. No one medication benefits all patients. Some people will turn out to be "non-responders." Respect the power of medications; all medications, even over-the-counter drugs, have adverse effects. Unfortunately, there is no way to predict whether a medication will elicit a favorable or an adverse effect. The only way to find out is to initiate treatment and see how you respond.

  7. Stay in contact with your physician and let him/her know the effects, beneficial or undesired, of the medication. If you or your physician is dissatisfied with how you are responding, discuss other strategies such as adjusting the dose or switching to an alternative treatment. Should you develop any serious problem(s) you suspect might be related to your medication, contact your physician or pharmacist immediately. Be alert to any changes in your health status or symptomatology.

  8. Try to be sensible with your use of medications. Take advantage of the substantial gains we have experienced with highly effective medications over the past decades. We strongly recommend the use of well-documented medications that offer important health benefits (see Chapter 5). At the same time, we discourage overutilization of non-essential medications. If you take five or more medications, it would be worthwhile to consult your primary care physician – a general internist, a geriatrician, a family practitioner, or a pediatrician –to coordinate the use of your multiple medications (see Chapters 37 and 38). It is likely that one or more medications can be terminated or drug doses lowered. As a result, you may feel better and also save money. Our broader views on over- and underutilization are presented in the next chapter.

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