Medication Safety: Tips When Starting New Prescriptions and Why Creating a List Is Important
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For most older adults, taking medications or supplements becomes a part of the daily routine and can improve quality of life for many. Still, as you get older, you should think twice about asking for a new medication or staying on medications that may no longer be necessary, as it could be dangerous to your overall health.
Why do medications affect older adults differently?
As we age, our bodies cannot process medication like when we were younger. The aging process can decrease our ability to absorb, process, and remove medications from our system. Because of this, some medications can create life-threatening conditions such as falls, memory problems, hospitalizations, and even death, like in the case of Alice Brennan. Alice died tragically at the hands of medication harm and health care system failures because she was given an inappropriate drug for a woman of her age, triggering a 6-week cascade to her death.
As we age, we become more sensitive to drugs because our bodies cannot process them as efficiently as when we are younger.
In fact, some medications can cause more harm to people over 65 than help. The American Geriatrics Society has developed a tool for health care providers that guides them to make informed decisions about medication safety when prescribing potentially harmful medications to older adults. Both patients and their doctors should become familiar with the Beers Criteria Medication List® list and consider the risks and benefits of these medications before they are prescribed and taken.
Tips when starting new medications: A guide for older adults
When a doctor prescribes a new medication, ask questions:
- What is the medication for?
- What are the benefits and risks of the medication?
- What are the potential side effects of the new medication?
- Are there any alternatives to taking the medication, such as physical therapy, change of diet, or exercise?
Be on the lookout for any new or unfamiliar symptoms, as they could be a warning sign of new medication problems. Some examples of symptoms include:
- Confusion
- Sleep problems
- Infections
- Nausea or diarrhea
- Feeling anxious
- Panic attacks
- Loss of appetite
- Weight loss
- Dizziness and falls
- Hallucinations
If you do experience new symptoms, this may be a sign that your body is reacting poorly to the new medication. Don’t be afraid to ask questions. Talk to your doctor, pharmacist, or someone in charge of your medication. Don’t stop asking until you know that the symptoms you are having are not related to the new medication.
Always notify your doctor, nurse, or pharmacist before making any changes to your medication.
What are “Never Meds”?
Because medications work differently as we age, they could become dangerous to you. Your doctor may advise you never to take them or stop taking them if you have already been prescribed them.
Did you know that when one of your doctors stops a medication, it is not automatically communicated to all members of your health care team, especially the hospital where you may be admitted someday?
In Alice’s case, when she was admitted to the hospital with a minor knee problem, her medication list in the hospital’s system said that she was prescribed a muscle relaxant, Flexeril. Although she was once prescribed it, her neurologist told her never to take it, so she did not and disposed of it. However, Flexiril did not come off her medication list in her medical record, and the doctors in the hospital gave it to her, assuming it was a part of her medication routine without asking her or telling her or her care partner. This was the beginning of Alice's medication harm journey that ended in her death.
The importance of creating medication lists and how it could save your life
Something as simple as having updated medication lists could save your life. It might have saved Alice’s. It is important to take charge and be proactive to ensure your health and safety. Here are some things you or a loved one should do to protect yourself from a similar fate, especially when going to the hospital or visiting a doctor.
Keep an updated list of all of your medications and include:
- Over-the-counter medications
- Vitamins
- Supplements
*Be sure to identify what you are taking them for.*
Keep an updated allergy list and include:
- Any known allergies
- Your “Never Meds”—this will alert the health care providers that you shouldn’t take the drug.
Be sure to:
- Carry your lists with you at all times.
- Provide your care partner or someone you trust with updated copies of both lists.
- Check that your doctors have an updated and accurate record of your current medications.
- Ask your doctor to review your medication lists annually. There may be medications that you no longer need or can be reduced. Remember, less is more.
- Don’t wait to be asked about your medication lists. Make it clear to your loved ones, care partner, and your health care team of any known “Never Meds” that you should not take.
Always notify your doctor, nurse, or pharmacist before changing any medication.
Get to know Team Alice and the work they do to prevent medication harm
Inspired by the tragic death of Alice Brennan due to medication harm and system failure, members from three senior centers in Western New York joined forces with the Western New York Deprescribing Partnership and the University at Buffalo Primary Care Research Institute to form Team Alice. Their goal: to generate actionable lessons to protect others from medication harm. The senior center members, called Elder Voices, worked with members of Team Alice to generate messages on medication harm and the importance of self-advocacy. Their hope is to save the Alice’s of the world.
This is the second article in a series from Team Alice, a project of The Center For Successful Aging at the University at Buffalo. Please visit Team Alice’s YouTube page for more information on medication safety.
Funding for this research was provided by RRF Foundation for Aging Grant #2019060 and USDeN NIA R24AG064025 subaward STE2196-17.
Photo of Alice Brennan courtesy of Team Alice.