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Living with Psoriatic Arthritis (PsA)

Medication Safety and Error Prevention, pt 1 Polypharmacy


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Medication Safety

Why are PsA Patients at Greater Risk of Medication Errors?

With chronic conditions, it isn't uncommon for patients to be prescribed a number of medications. As patients living with Psoriatic Arthritis, we may find that to be true for us as well. In the medical world, this is called: polypharmacy, and providers have realized the dangers associated with taking multiple medications. Many organizations including insurance companies, hospitals and physcian offices are beginning to take steps to help reduce the potential risks associated with polypharmacy. Below, you will find steps that you as a patient can take to help reduce these risks. Certainly in your time on LwPsA you have heard the phrase, "Be your own best advocate". This is just another step in that process.

Steps to Increase Accuracy & Safety
Medication Lists

Current patient advocacy recommendations include accurate and frequently updated medication lists. It is important to encourage each different provider you see to go over your medications list every time you are in for an appointment. You and they should have an accurate list of your current medications. One of the most common risks as a patient who takes multiple medications is errors in administration including overdosing, underdosing, missed medications, overprescription, and more. Keeping and frequently referring to an accurate medication list can help to prevent some of these errors.

  • What your list should include:
  1. Medication names (generic and brand), dose (mg, G, mL, etc.), frequency (morning, noon, night, three times per day, twice per day, etc.), condition for which med is prescribed, and prescriber
  2. All over the counter or non-prescription medications, dose, frequency, and reason for taking
  3. All supplements, herbals, vitamins, etc., including the dose, frequency, and reason for taking
  4. ANY allergies, including food allergies, severe side effects, reactions to CT contrast or dyes, skin sensitivities, any unsual reactions

Medication Review

Many, if not most, pharmacies offer a comprehensive medication review as part of their service to you, the customer. If they do not, find a new pharmacy. In a medication review, the pharmacist reviews all of your medications to ensure that you are on the best dosage, looks for interactions with other medications and duplicate prescriptions from different providers, ensures that you are taking the medication as directed and will often offer options for less expensive, generic medications when available. They will notify the prescriber with any errors and recommendations. This is a great service that should be taken advantage of. It is not unheard of for two providers to prescribe the same medication for the same patient, or for other errors to occur. Medication review can catch errors before they cause harm.

Some insurance companies with also offer a medication review with a licensed pharmacist. If you run into dead-ends with your local pharmacy, this is another avenue to try.


Communication
Make your providers and pharmacist speak to you about any new medications. With each new prescription, ask questions about how to best take the medication, any foods to avoid while taking it, the best time of day to take it, any common side effects to look for, or any dangerous side effects to report right away. Ask about drug interactions, and make sure that your over-the-counter and supplements have also been considered. Be sure to update your personal medication list and make sure that your other providers are made aware of the new medication. Keep a copy of your medication list on your person at all times (in a wallet or purse) in case of emergencies.


Limit Pharmacies and Prescribers
Another great tool available to each of us is to limit our pharmacist to one location. Find a pharmacy with staff who make time to counsel you when you have medication questions, has reasonable hours, and stick with them. Be sure to get all of your medications filled there, if at all possible. When you go to numerous, random pharmacies, it is nearly impossible for several pharmacists to help keep track of any potential problems with your other medications.

When possible, use your primary care doctor to direct your care and avoid self-referring to specialists. The more doctors you have, the more risk for errors in medications. Of course, there are times when meeting with specialists is called for, and at those times be sure to communicate any med changes with the other doctors who care for you. Encourage each member of your health care team to communicate with the others by forwarding visit notes, important changes, or discussing overlapping care. Communication is crucial to the quality of your care, and your providers should be willing to provide this as part of their service to you.


We all know how overwhelming managing the details of chronic illness can be. Many may not want to take on another task; however, managing polypharmacy is one service that your health team can assist you with, it requires little extra time or energy, and any extra effort is well rewarded with additional safety and security.