By Scott Scanlon / Refresh Editor
Larry Felckowski admits to being zealous when it comes to taking his medications, but he also has to admit he feels pretty good these days, despite his Type 2 diabetes.
Felckowski, of Cheektowaga, takes insulin several times a day, as well as small doses of high blood pressure and statin medications at bedtime.
He lines up his meds in a pair of pill boxes for two weeks out, on Sundays, while he’s doing the laundry. He tracks his blood sugar levels and medication use daily on a spreadsheet, and orders a 90-day supply of medications to more easily manage his refills. He also uses a pharmacy coach to help ensure he’s staying on track.
“It sounds like a lot of work, but by now it’s second-nature – and it’s important,” said the 48-year-old CitiGroup compliance officer.
Not everyone is so driven when it comes to medication adherence, and that’s too bad. Consequences include treatable diseases that needlessly wreak havoc – and sometimes death – on people who choose to ignore doctor’s orders, new strains of antibiotic-resistant bacteria and higher medical costs for us all.
“It may seem like everyone’s doing what they’re supposed to, but the statistics do not bear that out,” said Dr. Richard Vienne, who practices at Lifetime Health Medical Group in Amherst and is chief medical officer with Univera Healthcare.
As many as 20 percent of patients don’t fill new prescriptions and half of those with chronic conditions stop taking medications within six months. That has become a growing problem, according to the National Institutes of Health, American Heart Association and Centers for Disease Control and Prevention:
• Today, roughly three-quarters of all doctor, outpatient hospital and emergency room visits include drug therapy.
• Half of Americans – including nine out of 10 of those age 60 and older – take at least one prescription drug each month.
• During the past decade, the use of multiple prescriptions has climbed by 20 percent and the use of five or more drugs has skyrocketed by 70 percent.
• Poor medication adherence results in an estimated 125,000 deaths a year and costs the U.S. health care system nearly $300 billion annually on additional doctor, hospital and emergency room visits.
“Those numbers are very alarming,” Erie County Health Commissioner Dr. Gail Burstein said. “We have a high rate of chronic diseases in our county. We know that cardiovascular disease is a huge problem, as well as diabetes and many diseases relating to obesity. We also have high rates of cancer and other smoking-related illnesses, such as COPD and asthma, so it’s very important that people take medications as their health care providers prescribe.
“This is really more helping people stay healthy and live healthy with the chronic disease that they have.”
Several regional experts shared the following ways to do so:
1. Work with your experts: Generally, no matter how much time you spend online, you are not the best authority. Talk with your doctor and pharmacist to educate yourself.
“Understand that medications are prescribed for a reason,” said Scott V. Monte, owner of Mobile Pharmacy Solutions on the Buffalo Medical Campus. “Advocate for yourself. Ask, ‘Why am I on these therapies?’ ‘How long do I have to be on these therapies?’ ‘What can I expect from a side-effect standpoint?’ Share with your doctor or pharmacist a complete list of every prescription medicine, over-the-counter drug and supplement you take. These trained experts have the tools to determine what’s best for you and whether two drugs don’t mix very well.
2. Have a plan: Those who take several medications should have a written prescription plan, which they can put together with help from a pharmacist or loved one. Use a pill box or medication dispensing system that can help you keep better track. Ask your health care team or insurance company if there’s a way for you to get help managing your meds. Felckowski uses a coach from MedSense; Monte’s mobile pharmacy works with several referral agencies and comes to you.
3. Keep things simple: Take your medications at the same time each day. Keep your morning and nighttime meds near your toothbrush and those you take with food in the kitchen. Ask your doctor and pharmacist if you can limit taking a particular medication to once a day, instead of more often. “Work with a single pharmacy because they will be the hub to receive all the medications and they will be aware of all the interactions,” Vienne said.
4. Have backup: Make, and print, copies of your daily and weekly medication schedule – and don’t be afraid to ask your pharmacist to make one for you if that will ease your mind. And consider using a smartphone alarm or computer application to give you a nudge. If you can’t figure this out, ask your health provider or a family member for help.
5. Lean on loved ones: Burstein and Vienne encouraged family members to be available to relatives who might struggle under the weight of several medications and can use help organizing a medication plan and preparing pills for a day or week. When someone checks on loved ones to see how they’re doing generally, they always should remember to ask, “Hey, did you take your medications?” Vienne advised.
6. Respect chronic disease: The irony when it comes to some of the most effective pharmaceutical drugs is that those who take them for chronic diseases gain a false sense of security that they have been cured, when in fact a steady supply of medication is keeping a condition in check. That is especially true of mental illnesses, and “silent killers” that include high blood pressure and high cholesterol. There’s a reason you were prescribed these medications. Stop taking them at your own risk.