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As we know the aging clientelle are prone to symtoms associated with polypharmacy. Whilst reading I was delighted to run acroos the brown bag method. An effective way to take a drug history is rather than relying on the patient's medical record, ask them to bring all of his medications with him to the next visit. A recent study found that this method produces a more accurate list of the drugs an elderly patient takes. Be sure to tell your patient to bring in all the medications, including prescription and OTC drugs, topical preparations, herbal products, vitamins, and other supplements. Also ask if he is using any medications he gets from family or friends.

What say you?

Cameron

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Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

I agree with you, but sometimes the old lady or the old sir you are asking for can have some logistic problems if he/she have to carry all drugs or preparations he/she is taking yo your office!

Here, you can ask to his/her general practitioner for a complete list. They have only to push a button for printing a nice list. It is far more accurate since many older people can bring you the wrong medication also (they are unable to recognize what current medication they are taking now).

Also, you can phone their pharmacy where they usually know what medication they are taking currently.

Anyway, this is a common problem when you ask about medication to certain people. Here, it is typical the get the next reponse: "yes, I am taking the small white pills with the red line on the box, you know?"

Regards,

Javier

Many of my patients would need a shopping trolly to bring all their medicines in or suffer a rupture carrying them. Brown paper bags tend to dissolve in the Northern climate

I tend to opt for the repeat prescription form or a phonecall to the GP if I have any doubts at all.

I thoroughly enjoy a good guessing game of tablets-shape, size colour, sounds like...

GB

Javier & George

From the research I was reading the benefits of the brown bag approach was more to do with the OTC and self medications as well as the prescribed course of pharmacy. To help obviate Polypharmcy or Hyperpharmacotherapy the authors recommend the following questions:


1. Is each medication necessary?
2. Is the drug contraindicated in the elderly?
3. Are there duplicate medications?
4. Is the patient taking the lowest effective dosage?
5. Is the medication intended to treat the side effect of another medication?
6. Can the drug regimen be simplified?
7. Are there potential drug interactions?
8. Is the patient adherent?
9. Is the patient taking an OTC medication, an herbal product, or another person’s medication?

Cameron

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Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

There are a lot of articles, studies and protocols for avoiding Polypharmcy or Hyperpharmacotherapy among elders. But, unfortunatly in a country with a socialized medicine like mine (where drugs are free for retired people) it is almost impossible to control people medication. They feel like a right to take as much pills as they want (for the enjoying of the pharmaceutical industry).

Now, the government have engaged a national campaign for improving rational use of drugs. I dubt they will able to get results.

Also, there is an obvious lack of time for each patient on the national health system (a common problem also on socialized medicine countries). Thus, although all the questions you propose are right, there is not enough time for asking them.

Javier

Hi Cameron
Iain Wilson, Glasgow School 1979 - have greatly enjoyed your web articles re footwear and Australian radio programmes!
Re Polypharmacy. Our method here is to request that all Pats. bring repeat prescription counterfoil. This generally works although we have our share of defaulters. We would absolutely insist on it if comtemplating Nail surgery, as part of the pre - op checklist, and on those occasions where there is doubt, we would contact Pat`s General Practitioner. Of more concern however is the increasing use of "Natural" products and any serious interaction with prescribed Medicines.
Regards, Iain

Just stumbled on this:

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G'day,

Working in a small country town in central Victoria, Australia, the vast majority of my patients are elderly. With the DVA patients, it's usually not an issue as most of the local GPs just send out a new care plan every 12 months, even though they dont have to (neat eh?). Same for EPC patients. For the rest of them, it can be so hard to get a full pharmicotherapy picture of my patients. One trick I've found is encouraging the patients to carry a list of all their meds on a piece of paper in their wallets, just in case they have a fall in the street or a blackout or something, then it's safer all round. But I will give the brown paper bag idea a go for the obstinate ones.
Cheers!

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Adrian Misseri
B.Pod.,M.Hlth.Sci.(Pod.)

You know.. we could just cut it off.....?