I f you take several medications—some research suggests that older people take nine, on average—managing them may be something of a challenge. And during the pandemic, it’s especially important to have the right medications on hand so that you don’t have to make a mad dash to the pharmacy, says Gina Ayers, PharmD, a geriatrics clinical pharmacy specialist at the Cleveland Clinic.
In the COVID-19 era, when many older adults have put off doctor’s visits, it’s also key to ensure that you’re taking only the medications that are beneficial and not the ones that have outlived their usefulness or pose a health risk, Ayers adds.
You may be surprised at how often those two things can happen. A study published in 2019 in the journal BMC Geriatrics found that when pharmacy students went to older adults’ homes, they discovered that 40 percent had expired medications on hand, 15 percent had potentially inappropriate meds, and about a fifth had duplicate drugs. And a December 2019 University of Michigan national poll of older adults found that among those who took five or more prescription drugs, 32 percent also reported taking another five or more over-the-counter (OTC) meds or supplements, which can magnify the effects of prescription drugs or interact with them.
Here’s how to make medication management easier.
Get Your Regimen Reviewed
If you haven’t done an annual medication review—aka a brown-bag review—since the pandemic hit, it’s probably high time to do it. During this kind of review, a healthcare professional—a pharmacist, your primary care physician, or a nurse or physician assistant in your doctor’s office—takes a look at all your current prescription drugs, OTC medications, and supplements, as well as their dosages.
This review may be covered by insurance, and while it usually involves taking all these items to your doctor or pharmacist, you can opt to do it virtually if you prefer.
“Physically looking through bottles with a healthcare provider, even if it’s online, can often find duplications, excess supplies, expired drugs, and medication errors,” says Sunny Linnebur, PharmD, a clinical pharmacy specialist at the University of Colorado Hospital Seniors Clinic in Aurora and past president of the American Geriatrics Society.
Consider Mail-Order Meds
It’s pretty simple to do a drive-thru prescription pickup at a drugstore, and many pharmacies are offering this as well as deliveries. But the easiest way to make sure you get the prescription medications you use regularly in a timely manner is to use mail order, Linnebur says.
Set yourself up for a 90-day supply if your insurance will cover it. Automatic refills can help ensure that you don’t run out. Otherwise, reorder several weeks before you need another 90-day supply, so you don’t miss doses. If you run out, your physician can arrange for a “bridge” supply to cover you for 15 to 30 days until your mail-order prescription arrives, says Michael Hochman, MD, an internal medicine physician at Keck Medicine of USC in Los Angeles.
Be Careful About Rx Websites
It’s best to stick to mail-in services associated with local or national pharmacy chains or your medical insurance company. Be cautious with other internet sites, especially those from another country, no matter how tempting the low prices are. “Choosing to order prescriptions from outside the U.S. can increase the risks of receiving adulterated drugs or bypassing safety checks that U.S.-based pharmacies must include,” Linnebur says.
In fact, when the National Association of Boards of Pharmacy reviewed more than 22,000 prescription drug sites, it found that almost 95 percent were not operating in compliance with U.S. laws. One example: failure to require a prescription for the purchase of prescription-only medicine. If cost is a concern, consider asking your pharmacist about discount coupons for your drug or checking the Blink Health and GoodRx websites for coupons.
Have a Local Go-To Pharmacy
Even if you get all your regular medications by mail, it’s important to have a dependable local pharmacy where you can get prescriptions for acute conditions such as infections, says Chad Worz, PharmD, a geriatric pharmacist and chief executive of the American Society of Consultant Pharmacists. Make sure your mail-order service and local drugstore (and doctors) have a current record of everything you take so that you don’t accidentally double up on similar meds or take drugs that can interact with each other.
You can (and should) also use your local pharmacist if you have questions about prescription or OTC medications. For instance, certain OTC cough and cold drugs aren't recommended for older adults because they contain phenylephrine or pseudoephedrine, which can drive up blood pressure, or the antihistamine diphenhydramine, which has been linked to side effects such as dizziness, sleepiness, and even cognitive impairment in seniors.
It doesn’t matter whether you use a chain or an independent local pharmacy, Worz says, as long as the pharmacist takes the time to answer your questions clearly. (Try to time your pharmacy trip for early morning or midafternoon—before 4 p.m.—when it’s often less hectic.)
Spring-Clean Your Stuff
Once a year (why not now?) go through your medicine cabinet and make sure none of your prescription or OTC medications have expired, Linnebur says.
While it’s true that many medications may retain at least 70 percent of their original potency for a year or two after expiration, even after the container has been opened, it’s safest to have the most up-to-date drugs with the most up-to-date instructions. “There may be new dosing instructions or warnings, or the potency may have been changed,” she adds.
Editor’s Note: A version of this article also appeared in the May 2021 issue of Consumer Reports On Health.
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